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EP News: Clinical

Published:November 05, 2022DOI:https://doi.org/10.1016/j.hrthm.2022.11.001
      Butt et al (J Am Coll Cardiol 2022;80:1705, PMID 36041668) examined the effects of dapagliflozin (D) according to the presence or absence of atrial fibrillation (AF). A total of 6263 patients with New York Heart Association class II–IV heart failure (HF), left ventricular ejection fraction >40%, and elevated N-terminal pro–B-type natriuretic peptide levels were randomized to D or placebo. The primary outcome was a composite of cardiovascular death or worsening HF. Overall, 43.3% had no AF, 18.0% had paroxysmal AF, and 38.7% had persistent/permanent AF. The primary end point was higher in patients with AF, especially paroxysmal AF, driven by a higher rate of HF hospitalization: no AF, HF hospitalization rate per 100 person-years (4.5), paroxysmal AF (7.5), and persistent/permanent AF (6.4) (P < .001). The benefit of D on the primary outcome was consistent across AF types. The authors conclude that the beneficial effects of D compared with placebo on clinical events and symptoms were consistent, irrespective of the type of AF at baseline.
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