Early glomerular filtration rate decline is associated with hemoglobin rise following dapagliflozin initiation in heart failure with reduced ejection fraction.
Rev Esp Cardiol (Engl Ed)
; 76(10): 783-792, 2023 Oct.
Article
em En, Es
| MEDLINE
| ID: mdl-36958534
ABSTRACT
INTRODUCTION AND OBJECTIVES:
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) induce short-term changes in renal function and hemoglobin. Their pathophysiology is incompletely understood. We aimed to evaluate the relationship between 1- and 3-month estimated glomerular filtration rate (eGFR) and hemoglobin changes following initiation of dapagliflozin in patients with stable heart failure with reduced ejection fraction (HFrEF).METHODS:
This is a post hoc analysis of a randomized clinical trial that evaluated the effect of dapagliflozin on 1- and 3-month peak oxygen consumption in outpatients with stable HFrEF (DAPA-VO2 trial, NCT04197635). We used linear mixed regression analysis to assess the relationship between eGFR and hemoglobin changes across treatment arms.RESULTS:
A total of 87 patients were evaluated in this substudy. The mean age was 67.0± 10.5 years, and 21 (24.1%) were women. The mean baseline eGFR and hemoglobin were 66.9±20.7mL/min/1.73m2 and 14.3±1.7g/dL, respectively. Compared with placebo, eGFR did not significantly change at either time points in the dapagliflozin group, but hemoglobin significantly increased at 1 and 3 months. At 1 month, the hemoglobin increase was related to decreases in eGFR only in the dapagliflozin arm (P <.001). At 3 months, there was no significant association in either treatment arms (P=.123). Changes in eGFR were not associated with changes in peak oxygen consumption, quality of life, or natriuretic peptides.CONCLUSIONS:
In patients with stable HFrEF, 1-month changes in eGFR induced by dapagliflozin are inversely related to changes in hemoglobin. This association was no longer significant at 3 months.Palavras-chave
Cambios en la hemoglobina; Cambios en la tasa de filtrado glomerular estimada; Capacidad funcional máxima; Changes in estimated glomerular filtration rate; Changes in hemoglobin; Dapagliflozin; Dapagliflozina; Heart failure with reduced ejection fraction; Insuficiencia cardiaca con fracción de eyección reducida; Maximal functional capacity
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Disfunção Ventricular Esquerda
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Inibidores do Transportador 2 de Sódio-Glicose
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Insuficiência Cardíaca
Tipo de estudo:
Clinical_trials
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
/
Es
Ano de publicação:
2023
Tipo de documento:
Article