Original scientific paper
https://doi.org/10.3325/cmj.2025.66.135
Dapagliflozin vs empagliflozin in patients with chronic heart failure: a registry analysis
Ivana Jurin
; Department of Cardiovascular Diseases, University Hospital Dubrava, Zagreb, Croatia
Irzal Hadžibegović
; Department of Cardiovascular Diseases, University Hospital Dubrava, Zagreb, Croatia
Hrvoje Jurin
; Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Zagreb, Croatia
Diana Rudan
; University North, Koprivnica, Croatia
Nikola Pavlović
; Department of Cardiovascular Diseases, University Hospital Dubrava, Zagreb, Croatia
Marija Radić
; Department of Cardiovascular Diseases, University Hospital Dubrava, Zagreb, Croatia
Šime Manola
; Zagreb University School of Medicine, Zagreb, Croatia
Vladimir Trkulja
; Department of Pharmacology and Clinical Pharmacology, Zagreb University School of Medicine, Zagreb, Croatia
*
* Corresponding author.
Abstract
Aim To assess the relative efficacy of dapagliflozin and em
pagliflozin in routinely treated chronic heart failure (CHF)
patients.
Methods Data from a registry of prevalent and incident
CHF patients were used to set up cohorts (new-user de
sign) of patients started on dapagliflozin or empagliflozin
in addition to other guideline-directed therapy. Cohorts
were mutually balanced on a range of characteristics,
and were assessed for the incidence of a composite of
all-cause death/major adverse cardiac events (primary
outcome) over the initial 6 months of treatment, and for
New York Heart Association (NYHA) functional class at 6
months (secondary outcome). Frequentist and Bayes es
timates were generated for the dapagliflozin vs empagli
flozin comparison.
Results In both prevalent (dapagliflozin n = 393, empagli
flozin n = 328) and incident (dapagliflozin n = 124, empa
gliflozin n = 116) patients, those prescribed dapagliflozin
had somewhat higher incidence of the primary outcome,
but the confidence intervals were wide (RR = 1.385, 95%CI
0.882-2.173 [prevalent], RR = 2.192, 95%CI 0.765-6.282 [inci
dent]), and were more likely to present with a worse NYHA
class at 6 months (OR = 1.552, 95%CI 1.142-2.108 [prev
alent], OR = 1.503, 95%CI 0.844-2.676 [incident]). In the
pooled data, primary events (n = 102) were more common
in dapagliflozin-prescribed patients (frequentist estimate
RR = 1.519, 95%CI 1.239-1.861; Bayes RR = 1.380, 95%CrI
0.981-1.944). Dapagliflozin-prescribed patients were
also more likely to have a worse NYHA class at 6 months
(OR = 1.540, 95%CI 1.208-1.962; Bayes OR = 1.425, 95%CrI
1.098-1.781).
Conclusion CHF patients prescribed with dapagliflozin
had poorer outcomes than their empagliflozin-prescribed
peers over the initial 6 months of treatment. Data empha
size a need for a direct randomized comparison of the two
treatments in this setting.
Keywords
Hrčak ID:
352480
URI
Publication date:
23.4.2025.
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