DECLARE-TIMI 58 HFrEF

Dr. Peter Block interviews presenter Dr. Eri Toda Kato regarding dapagliflozin on HF and mortality in diabetes based on EF (DECLARE TIMI-58). Visit for full meeting coverage.

I’m peter block here at acc 2019 in new orleans on my left is eric otto from kyoto in japan and he has worked on davic a thousand we talked about depe closing a lot at this meeting it’s the hot drug for diabetes and you’re the heart failure type so ari tell me about your trials specifically topical ozan seems to be the cure-all for everything in diabetes but heart

Failure is your speciality so what did you find so in our study we evaluated the impact of ejection fraction on clinical benefit of history ot to eva’dur type conclusion with special interest in heart failure and mortality and we found to product there are two primary funding for our study one it’s a topical flows in reduces hospitalization for heart failure

Regardless obstruction fraction and that includes patient with heart failure with preserved rectum fractions okay so let me interrupt that a minute because that’s an important sort of a subgroup analysis isn’t it i mean patients with preserved ejection fraction and heart failure with you know arguably non-compliance of their left ventricle really have a different

Subgroup of physiology don’t they why does this work so well well it is difficult to tell why it works from the clinical trials that proposing reduces blood pressure reduces improve glucose of course and improves nash so they’re all it’s really multifactorial so there’s no one reason why the person has death but we think it’s more than just a fluid loss okay

So the statin for diabetes if you will yes okay so what else did you find besides the fact that across all groups it seems to reduce hospitalization for heart failure the other important finding was that a proposed and redo is cardiovascular death and all cause mortality impatient with chef raff and now this was really a robust finding so it reduces all cause

Mortality by 41% and it reduces cardiovascular death by 45% so these are hard endpoints yes and these were achieved on top of evidence-based heart failure therapies including aca feeder and beta blockers so it is surprising that they really enjoy okay so if i’m taking care of a cardiology patients in whom i done a stent procedure now i see them because they have

Heart failure later on and they’re on maximum therapy kotappa callosum is in addition that would give me further improvement in outcomes is that a fair statement i think that’s what we found in our study perfect so what’s the take-home message here an area we’ve got a drug that everybody now is touting is the right thing to do to use for diabetes should we use it

Earlier that’s a very good question you know we usually use topical close and on top of metformin we haven’t tested whether it works as a primary choice that’s for another study that we should be looking forward to but i think from what we found so far it’s a there’s a robust evidence that it may work as a for therapy so yes i think it’s a very official in you know

Type of diabetes peers you should not have it that’s a good question we’re still looking forward to that so we’re digging into details of other findings we have to have totality of evidence so we were not really sure at this moment we’re looking into so we are looking into a high-risk group including peripheral artery disease patients so that would be presented

At acc to actually we’ve already talked about that in one of the interviews and i dunno i know that those beautiful disease patients do better as well right so it’s gonna be tricky to find out but capital fulton is clearly on the map if anyone’s out there taking care of diabetic patients think about that pick flows and to add to your armamentarium thank you airy thank you you

Transcribed from video
DECLARE-TIMI 58 HFrEF | ACC.19 By American College of Cardiology