Dr. Tomasz Jurga discusses the DELIVER trial with co-host, Dr. Liz Wang.
0:00-2:10: Introduction
2:11-6:05: DELIVER trial overview
6:06-12:51: History of HFpEF treatment
12:52-24:18: DELIVER overall thoughts
24:19-25:18: Timing of initiation
25:19-29:26: SGLT2 inhibitor place in HFpEF therapy
29:27-32:59: Considerations for adverse effects and monitoring
33:00-35:15: Final thoughts
35:16-35:54: Closing
References:
DELIVER
Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. N Engl J Med. 2022;387(12):1089-1098. doi:10.1056/NEJMoa2206286
DAPA HF
McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381(21):1995-2008. doi:10.1056/NEJMoa1911303
CHARM-Preserved
Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003;362(9386):777-781. doi:10.1016/S0140-6736(03)14285-7
TOPCAT
Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383-1392. doi:10.1056/NEJMoa1313731
RELAX
Redfield MM, Chen HH, Borlaug BA, et al. Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial. JAMA. 2013;309(12):1268-1277. doi:10.1001/jama.2013.2024
NEAT-HFpEF
Redfield MM, Anstrom KJ, Levine JA, et al. Isosorbide Mononitrate in Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2015;373(24):2314-2324. doi:10.1056/NEJMoa1510774
PARAGON-HF
Solomon SD, McMurray JJV, Anand IS, et al. Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2019;381(17):1609-1620. doi:10.1056/NEJMoa1908655
VITALITY-HFpEF
Armstrong PW, Lam CSP, Anstrom KJ, et al. Effect of Vericiguat vs Placebo on Quality of Life in Patients With Heart Failure and Preserved Ejection Fraction: The VITALITY-HFpEF Randomized Clinical Trial [published correction appears in JAMA. 2021 Feb 2;325(5):494]. JAMA. 2020;324(15):1512-1521. doi:10.1001/jama.2020.15922
EMPEROR-Preserved
Anker SD, Butler J, Filippatos G, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038
EMPULSE
Biegus J, Voors AA, Collins SP, et al. Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial [published online ahead of print, 2022 Oct 18]. Eur Heart J. 2022;ehac530. doi:10.1093/eurheartj/ehac530
EMPAG HF
Schulze PC, Bogoviku J, Westphal J, et al. Effects of Early Empagliflozin Initiation on Diuresis and Kidney Function in Patients With Acute Decompensated Heart Failure (EMPAG-HF). Circulation. 2022;146(4):289-298. doi:10.1161/CIRCULATIONAHA.122.059038
Vaduganathan M, Docherty KF, Claggett BL, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. Lancet. 2022;400(10354):757-767. doi:10.1016/S0140-6736(22)01429-5
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