{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:24:13Z","timestamp":1783463053417,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accp1.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Clinical Pharma"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Dapagliflozin has demonstrated multiple benefits in clinical trials for heart failure with reduced ejection fraction (HFrEF), but older patients with multiple comorbidities were often excluded. This study aimed to evaluate the effectiveness and safety of dapagliflozin in a real\u2010world population of HFrEF patients. This retrospective study included HFrEF patients from a tertiary hospital, who initiated dapagliflozin between January 202 and December 2022. The mean follow\u2010up was 15.3 \u00b1 8.3 months. Each patient served as their own control to compare left ventricular ejection fraction (LVEF), laboratory parameters, and time\u2010dependent events, such as heart failure (HF) readmissions. A total of 155 HFrEF patients (mean age 68.5 \u00b1 14.5 years; 75.5% male) were included. Of these, 47.1% had non\u2010ischemic heart disease, 49.0% had type 2 diabetes mellitus, and most were on beta\u2010blockers, loop diuretics and angiotensin\u2010converting enzyme inhibitor, angiotensin II receptor blocker, or angiotensin receptor neprilysin inhibitor. LVEF improved from 29.2% to 34.3% (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;\u00a0.001), with significant reductions in body weight and heart rate (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;\u00a0.001). HF\u2010related emergency room visits decreased (0.68 \u00b1 1.06 to 0.58 \u00b1 0.96;\n                    <jats:italic>P<\/jats:italic>\n                    =\u00a0.329). Renal function declined, with glomerular filtration rate decreasing from 67.6 \u00b1 25.2 to 55.2 \u00b1 30.8 mL\/min\/1.73 m\n                    <jats:sup>2<\/jats:sup>\n                    (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;\u00a0.001), particularly in older patients (HR 1.033; 95% CI: 1.004\u20101.063) and those with higher baseline heart rate (HR 1.028; 95% CI: 1.011\u20101.045). Severe adverse drug reactions occurred in 3.9% of patients, with hypotension (12.9%) being the most common. In conclusion, dapagliflozin demonstrated a favorable safety profile and significant hemodynamic benefits, improving LVEF and stabilizing HF progression in a real\u2010world HFrEF population.\n                  <\/jats:p>","DOI":"10.1002\/jcph.70082","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T13:27:10Z","timestamp":1753277230000},"page":"1900-1907","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Dapagliflozin on Heart Failure with Reduced Ejection Fraction: A Real\u2010World Study"],"prefix":"10.1002","volume":"65","author":[{"given":"Francisca","family":"Augusto","sequence":"first","affiliation":[{"name":"Instituto de Farmacologia e Terap\u00eautica Experimental da Faculdade de Medicina Universidade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia","family":"Paiva","sequence":"additional","affiliation":[{"name":"Instituto de Farmacologia e Terap\u00eautica Experimental da Faculdade de Medicina Universidade de Coimbra  Coimbra Portugal"},{"name":"Unidade de Farmacologia Cl\u00ednica Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"F\u00e9lix","sequence":"additional","affiliation":[{"name":"Instituto de Farmacologia e Terap\u00eautica Experimental da Faculdade de Medicina Universidade de Coimbra  Coimbra Portugal"},{"name":"Unidade de Farmacologia Cl\u00ednica Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4829-9446","authenticated-orcid":false,"given":"In\u00eas","family":"Jord\u00e3o","sequence":"additional","affiliation":[{"name":"Instituto de Farmacologia e Terap\u00eautica Experimental da Faculdade de Medicina Universidade de Coimbra  Coimbra Portugal"},{"name":"Unidade de Farmacologia Cl\u00ednica Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2159-802X","authenticated-orcid":false,"given":"Miguel","family":"Costa","sequence":"additional","affiliation":[{"name":"Instituto de Farmacologia e Terap\u00eautica Experimental da Faculdade de Medicina Universidade de Coimbra  Coimbra Portugal"},{"name":"Unidade de Farmacologia Cl\u00ednica Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia","family":"Dias","sequence":"additional","affiliation":[{"name":"Unidade de Farmacologia Cl\u00ednica Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Parente","sequence":"additional","affiliation":[{"name":"Unidade de Farmacologia Cl\u00ednica Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lino","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cardiologia Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Machado","sequence":"additional","affiliation":[{"name":"Servi\u00e7os Farmac\u00eauticos Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nat\u00e1lia","family":"Ant\u00f3nio","sequence":"additional","affiliation":[{"name":"Instituto de Farmacologia e Terap\u00eautica Experimental da Faculdade de Medicina Universidade de Coimbra  Coimbra Portugal"},{"name":"Unidade de Farmacologia Cl\u00ednica Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"},{"name":"Servi\u00e7o de Cardiologia Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad192"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812389"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1432"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa183"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010379"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad195"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2397"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.053659"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/1894155"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40256\u2010021\u201000503\u20108"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911303"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvab056"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.047077"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.058910"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010021\u201001989\u2010z"}],"container-title":["The Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcph.70082","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcph.70082","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcph.70082","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:06:45Z","timestamp":1772982405000},"score":1,"resource":{"primary":{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/10.1002\/jcph.70082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,23]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/jcph.70082"],"URL":"https:\/\/doi.org\/10.1002\/jcph.70082","archive":["Portico"],"relation":{},"ISSN":["0091-2700","1552-4604"],"issn-type":[{"value":"0091-2700","type":"print"},{"value":"1552-4604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,23]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}