loading page

Dapagliflozin vs. empagliflozin in patients with chronic heart failure: a single-center registry analysis
  • +5
  • Ivana Jurin,
  • Irzal Hadžibegović,
  • Hrvoje Jurin,
  • Diana Rudan,
  • Nikola Pavlović,
  • Marija Radić,
  • Šime Manola,
  • Vladimir Trkulja
Ivana Jurin
Dubrava Clinical Hospital
Author Profile
Irzal Hadžibegović
Dubrava Clinical Hospital
Author Profile
Hrvoje Jurin
University Hospital Centre Zagreb Department of Cardiovascular Diseases
Author Profile
Diana Rudan
Dubrava Clinical Hospital
Author Profile
Nikola Pavlović
Dubrava Clinical Hospital
Author Profile
Marija Radić
Dubrava Clinical Hospital
Author Profile
Šime Manola
Dubrava Clinical Hospital
Author Profile
Vladimir Trkulja
Department of Pharmacology, School of Medicine, University of Zagreb

Corresponding Author:vladimir.trkulja@mef.hr

Author Profile

Abstract

Purpose. To assess relative efficacy of dapagliflozin and empagliflozin in routinely treated chronic heart failure (CHF) patients. Methods. In this single-center registry analysis, prevalent and incident CHF patients with a wide range of left ventricular ejection fraction values started on dapagliflozin or empagliflozin in addition to other guideline-directed therapy were mutually balanced on a range of characteristics, and were assessed for incidence of a composite of all-cause death/major adverse cardiac events (primary outcome) over the initial 6 months of treatment, and for New Your Heart Association (NYHA) functional class at 6 months (secondary outcome). Frequentist and Bayes (with a moderately informed skeptical prior) estimates were generated for dapagliflozin vs. empagliflozin comparison. Results. In both prevalent (dapagliflozin n=393, empagliflozin n=328) and incident (dapagliflozin n=124, empagliflozin n=116) patients, those prescribed dapagliflozin had somewhat higher incidence of the primary outcome and were more likely to present with a worse NYHA class at 6 months, but the estimates were imprecise. In the pooled data, primary events (102 in total) were more common in dapagliflozin-prescribed patients (frequentist estimate RR=1.519, 95%CI 1.239-1.861; Bayes RR=1.380, 95%CrI 0.981-1.944). Dapagliflozin-prescribed patients were also were more likely to have a worse NYHA class at 6 months (OR=1.540, 95%CI 1.208-1.962; Bayes OR=1.425, 95%CrI 1.098-1.781). Conclusion. CHF patients prescribed with dapagliflozin apparently had poorer outcomes than those prescribed with empagliflozin over the initial 6 months of treatment. Data emphasize a need for a direct randomized comparison of the two treatments in this setting.