A recent study aimed to investigate the efficacy of dapagliflozin according to the frailty status of patients with heart failure (HF).

This was a post hoc analysis of a phase 3 randomized clinical trial (RCT) that utilized the Rockwood cumulative deficit approach, in DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure). Patients with symptomatic HF were included – who had a left ventricular ejection fraction (LVEF) of ≤40% and an elevated natriuretic peptide (NP).

The frailty index (FI) could be estimated in 4,742 out of the 4,744 patients randomly assigned in DAPA-HF. Overall, 50.4% of the patients were categorized as FI class 1; 33.9% as FI class 2; and 15.7% as FI class 3. All patients were followed up for a median of 18.2 months. 

The results revealed that Dapagliflozin could lower the risk for worsening HF or cardiovascular death, regardless of FI class. The benefits were similar for other clinical events and health status. Notably, the absolute reductions were usually greater in the frailest of patients. In addition, reports of serious adverse events were infrequent with this drug, while the patient compliance remained good, regardless of the FI class.

Source: Annals of Internal Medicine. 2022 Apr 26. doi: 10.7326/M21-4776.