Influence of diabetes mellitus on dapagliflozin response after transcatheter aortic valve replacement (TAVR): insights from the DAPA-TAVI trial.

What was studied

This was a planned subgroup analysis of the DAPA-TAVI trial. The trial enrolled 1222 people with severe aortic stenosis. They were having a valve replacement in Spain. All had prior heart failure. The team asked if diabetes changes the benefit of dapagliflozin. 537 people had diabetes. The main outcome was death or worsening heart failure at 12 months.

What they found

In people with diabetes, dapagliflozin cut deaths or worsening heart failure versus standard care. In people without diabetes, the cut was smaller and not significant. Genital infections were more common on dapagliflozin in people with diabetes. Symptomatic low blood pressure was more common in those without diabetes. Serious adverse events did not differ significantly.

What it means for patients

The team says dapagliflozin lowered the risk of death or worse heart failure. This was in people with diabetes. It says the apparent bigger gain in diabetes deserves more study.

Why it is not certain yet

This was a subgroup analysis, which cannot settle questions on its own. No significant interaction between diabetes status and treatment effect was seen. Follow-up was 12 months. All centres were in Spain. Other teams would need to test the same idea. The abstract does not name every limit of the work. These are early signs, and they may change as new data come.

Source

Influence of diabetes mellitus on dapagliflozin response after transcatheter aortic valve replacement (TAVR): insights from the DAPA-TAVI trial.

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