Dapagliflozin in Myocardial Infarction without Diabetes or Heart Failure

达帕格列嗪 医学 危险系数 心力衰竭 心肌梗塞 内科学 安慰剂 心脏病学 心房颤动 糖尿病 置信区间 2型糖尿病 内分泌学 替代医学 病理
作者
Stefan James,David Erlinge,Robert F. Storey,Darren K. McGuire,Mark de Belder,Niclas Eriksson,Kasper Andersen,David Austin,Gabriel Arefalk,David Carrick,Robin Hofmann,Stephen P. Hoole,Daniel A. Jones,Kelvin Lee,Hans Tygesen,Peter A. Johansson,Anna Maria Langkilde,Wilhelm Ridderstråle,Ehsan Parvaresh Rizi,John Deanfield,Jonas Oldgren
出处
期刊:NEJM evidence [New England Journal of Medicine]
卷期号:3 (2) 被引量:105
标识
DOI:10.1056/evidoa2300286
摘要

BACKGROUND: In patients with acute myocardial infarction (MI), therapies that could further reduce the risk of adverse cardiovascular and metabolic outcomes are needed. METHODS: In this international registry-based, randomized, double-blind trial, patients without prior diabetes or chronic heart failure, presenting with acute MI and impaired left ventricular systolic function, were randomly assigned 10 mg of dapagliflozin or placebo, given once daily. The primary outcome was the hierarchical composite of death, hospitalization for heart failure, nonfatal MI, atrial fibrillation/flutter, type 2 diabetes mellitus, New York Heart Association Functional Classification at the last visit, and body weight decrease of 5% or greater at the last visit using the win ratio analysis method. The key secondary outcome was the same hierarchical composite excluding the body weight component. RESULTS: We enrolled 4017 patients of whom 2019 were assigned to dapagliflozin and 1998 to placebo. The analysis of the primary hierarchical composite outcome resulted in significantly more wins for dapagliflozin than for placebo (win ratio, 1.34; 95% confidence interval [CI], 1.20 to 1.50; P<0.001). The win ratio outcome, which was adopted in a change of analysis during trial performance because of low event accrual, was mainly driven by the added cardiometabolic outcomes. The composite of time to cardiovascular death/hospitalization for heart failure occurred in 50/2019 (2.5%) patients assigned to dapagliflozin and 52/1998 (2.6%) patients assigned to placebo (hazard ratio, 0.95; 95% CI, 0.64 to 1.40). The rates of other cardiovascular events were low, with differences between the groups not reaching nominal statistical significance. No safety concerns were identified. CONCLUSIONS: In patients with acute MI as noted above, after approximately 1 year of treatment with dapagliflozin there were significant benefits with regard to improvement in cardiometabolic outcomes but no impact on the composite of cardiovascular death or hospitalization for heart failure compared with placebo. (Funded by AstraZeneca; ClinicalTrial.gov number, NCT04564742.)
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
亭子完成签到,获得积分10
1秒前
SciGPT应助YCu采纳,获得30
1秒前
652183758完成签到 ,获得积分10
1秒前
万能的小叮当完成签到,获得积分0
1秒前
yeyuchenfeng完成签到,获得积分10
3秒前
居居侠完成签到 ,获得积分10
3秒前
RYK完成签到 ,获得积分10
6秒前
ywindm完成签到,获得积分10
7秒前
7秒前
HLT完成签到 ,获得积分10
8秒前
QYY完成签到,获得积分10
9秒前
10秒前
邓博完成签到,获得积分10
11秒前
Akim应助kong采纳,获得200
12秒前
Amon完成签到,获得积分10
12秒前
啊啊啊啊完成签到,获得积分10
13秒前
lily完成签到 ,获得积分10
14秒前
Theodore完成签到,获得积分10
14秒前
小科完成签到,获得积分10
15秒前
23完成签到,获得积分10
16秒前
颖涵完成签到,获得积分10
16秒前
科研通AI5应助好困采纳,获得10
16秒前
shanshan完成签到,获得积分10
16秒前
微笑的白萱完成签到,获得积分20
17秒前
maxyer完成签到,获得积分10
18秒前
叶子完成签到,获得积分10
18秒前
花开米兰城完成签到,获得积分10
21秒前
呜呼啦呼完成签到 ,获得积分10
21秒前
yuehan完成签到 ,获得积分0
22秒前
小马哥完成签到,获得积分10
23秒前
俞孤风完成签到,获得积分10
24秒前
开心寄松完成签到,获得积分10
25秒前
25秒前
CAE上路到上吊完成签到,获得积分10
25秒前
hhh完成签到,获得积分10
25秒前
zyy完成签到 ,获得积分10
25秒前
烟雨发布了新的文献求助10
25秒前
整齐百褶裙完成签到 ,获得积分10
26秒前
跳跳糖完成签到,获得积分10
31秒前
zhangyulu完成签到 ,获得积分10
31秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968578
求助须知:如何正确求助?哪些是违规求助? 3513406
关于积分的说明 11167631
捐赠科研通 3248853
什么是DOI,文献DOI怎么找? 1794499
邀请新用户注册赠送积分活动 875150
科研通“疑难数据库(出版商)”最低求助积分说明 804671