Effect of dapagliflozin therapy on achieving cardiovascular mortality target indicators in patients with heart failure

M V Zhuravleva,Yu V Gagarina,S V Villevalde,I V Zhirov,T V Marin,S N Tereshchenko

doi:10.15829/1560-4071-2021-4800

Abstract

Aim. To assess the effect of therapy with sodium glucose co-transporter type 2 inhibitor dapagliflozin in patients with heart failure with reduced ejection fraction (CHrEF) on the state cardiovascular mortality target indicators.Material and methods. All adult Russian patients with NYHA class II-IV HFrEF (left ventricular ejection fraction ≤40%) were considered as the target population. The characteristics of patients in the study corresponded to those in the Russian Hospital HF Registry (RUS-HFR). The study suggests that the use of dapagliflozin in addition to standard therapy will be expanded by 10% of the patient population annually in 2022-24. Cardiovascular mortality modeling was performed based on the extrapolation of DAPA-HF study result. The number of deaths that can be prevented was calculated when using dapagliflozin in addition to standard therapy. Further, the contribution of prevented deaths with dapagliflozin therapy to the achievement of federal and regional cardiovascular mortality target indicators (1, 2 and 3 years) was calculated.Results. The use of dapagliflozin in addition to standard therapy for patients with NYHA class II-IV CHrEF with the expansion of dapagliflozin therapy by 10% of the patient population annually will additionally prevent 1729 cardiovascular death in the first year. This will ensure the implementation of cardiovascular mortality target indicators in Russia in 2022 by 11,8%. In the second year, 3769 cardiovascular deaths will be prevented, which will ensure the implementation of target indicators in 2023 by 17,2%. In the third year, 5465 cardiovascular deaths prevented, which will ensure the implementation of implementation of target indicators in 2024 by 18,7%.Conclusion. The use of dapagliflozin in addition to standard therapy for patients with NYHA class II-IV CHrEF will ensure the implementation of implementation of target indicators in 2024 by 18,7%.

Highlights

The study suggests that the use of dapagliflozin in addition to standard therapy will be expanded by 10% of the patient population annually in 2022-24
The use of dapagliflozin in addition to standard therapy for patients with NYHA class II-IV CHrEF with the expansion of dapagliflozin therapy by 10% of the patient population annually will prevent 1729 cardiovascular death in the first year
The use of dapagliflozin in addition to standard therapy for patients with NYHA class II-IV CHrEF will ensure the implementation of implementation of target indicators in 2024 by 18,7%

Summary

Results

The use of dapagliflozin in addition to standard therapy for patients with NYHA class II-IV CHrEF with the expansion of dapagliflozin therapy by 10% of the patient population annually will prevent 1729 cardiovascular death in the first year. В частности, одна из целей государственной программы (ГП) РФ “Развитие здравоохранения” и основная цель федерального проекта “Борьба с сердечно-сосудистыми заболеваниями” (ССЗ), установленная в 2017г — снижение смертности от БСК от базового значения 587,6 случаев на 100 тыс. Населения в 2017г до 450 случаев на 100 тыс. Населения [2], поэтому в 2021г целевые показатели по снижению были пересмотрены в сторону смягчения до 555 случаев на 100 тыс. Снижение смертности населения от БСК на 13,2% за 4 года Направленная на решение проблемы недостаточного ЛО пациентов, перенесших острые сердечно-сосудистые события, несомненно, положительно сказывается на достижении целевого показателя (ЦП) “снижение смертности населения от БСК” ГП “Развитие здравоохранения”.

КЛИНПИЕКРАЕИДФОВАРАМЯ АСКТОАТТЬЕЯРАПИЯ

ФК ХСН I ФК II ФК III ФК IV ФК

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