{"id":"f33da3ced546","type":"article","url":"https://hartvaat.nl/2025/12/01/dapagliflozine-na-mi-naar-ef-cardiometabole-uitkomsten/","title":"Dapagliflozine na MI naar EF: cardiometabole uitkomsten","title_en":"Cardiometabolic outcomes with dapagliflozin after myocardial infarction by baseline ejection fraction: DAPA-MI.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["dapa-hf","emperor-trials"],"journal":"ESC heart failure","doi":"10.1002/ehf2.15420","source_url":"https://doi.org/10.1002/ehf2.15420","authors":["David Erlinge","Stefan James","John Deanfield","Niclas Eriksson","Mark de Belder","Monér Alchay","David Austin","Daniel A Jones","Annica Ravn-Fischer","Sofia Sederholm Lawesson","Nikunj Shah","Julian W Strange","Karolina Szummer","Wilhelm Ridderstråle","Ehsan Parvaresh Rizi","Anna Maria Langkilde","Peter A Johansson","Darren K McGuire","Jonas Oldgren","Robert F Storey"],"significance":5,"published":"2025-12-01","source_date":"2025-12-01","image":"","kennis":[],"congress":"","summary_en":"Analysis of DAPA-MI assessed dapagliflozin after acute MI stratified by baseline ejection fraction. The cardiometabolic benefit was more pronounced at lower EF values, consistent with the established heart failure indication for SGLT2 inhibitors.","created":"2026-07-03T10:32:01Z","updated":"2026-07-03T18:39:19Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse onderzocht het effect van dapagliflozine na MI stratificerend naar EF. Het voordeel concentreerde zich bij lagere EF-waarden, consistent met de HF-indicatie.","abstract_original":"AIMS: In the randomized DAPA-MI clinical trial, 10 mg of dapagliflozin once daily improved cardiometabolic outcomes versus placebo after acute myocardial infarction (MI) in patients without established diabetes or heart failure (HF). We assessed associations between baseline left ventricular ejection fraction (LVEF) and cardiometabolic outcomes in DAPA-MI. METHODS: The primary outcome, assessed using the win ratio method, was the hierarchical composite of death, hospitalization for HF, non-fatal MI, atrial fibrillation/flutter, Type 2 diabetes, New York Heart Association classification at last visit and body weight decrease of ≥5% from baseline to last visit. For the present analysis, patients were categorized using LVEF at randomization (<50% or ≥50%). RESULTS: Of the DAPA-MI participants with available LVEF data who received ≥1 dose of study drug (n = 3751), 2913 (77.7%) had LVEF <50% and 838 (22.3%) had LVEF ≥50%. The primary hierarchical composite outcome resulted in a win ratio favouring dapagliflozin of 1.38 (95% CI: 1.21, 1.57; P < 0.001) in patients with LVEF <50% and 1.32 (1.00, 1.73; P = 0.048) in patients with LVEF ≥ 50% (P interaction = 0.76). In a sensitivity analysis excluding patients with LVEF <30%, the primary hierarchical composite outcome resulted in a win ratio favouring dapagliflozin of 1.40 (95% CI: 1.22, 1.61; P < 0.001). There were no significant interactions between baseline LVEF and any secondary outcomes. CONCLUSIONS: Regardless of baseline LVEF, dapagliflozin resulted in significant cardiometabolic benefits versus placebo, although there was no impact on the composite of cardiovascular death or hospitalization for HF."}