{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:33:44Z","timestamp":1792870424560,"version":"4.5.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"31","license":[{"start":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T00:00:00Z","timestamp":1684800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Dapagliflozin reduced the combined risk of worsening heart failure or cardiovascular death among patients with heart failure with mildly reduced or preserved ejection fraction. In this study, the safety and efficacy of dapagliflozin according to background diuretic therapy and the influence of dapagliflozin on longitudinal diuretic use were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>In this pre-specified analysis of the Dapagliflozin Evaluation to Improve the LIVEs of Patients With Preserved Ejection Fraction Heart Failure (DELIVER) trial, the effects of dapagliflozin vs. placebo were assessed in the following subgroups: no diuretic, non-loop diuretic, and loop diuretic furosemide equivalent doses of &amp;lt;40, 40, and &amp;gt;40 mg, respectively. Of the 6263 randomized patients, 683 (10.9%) were on no diuretic, 769 (12.3%) were on a non-loop diuretic, and 4811 (76.8%) were on a loop diuretic at baseline. Treatment benefits of dapagliflozin on the primary composite outcome were consistent by diuretic use categories (P \u00a0interaction = 0.64) or loop diuretic dose (P \u00a0interaction = 0.57). Serious adverse events were similar between dapagliflozin and placebo arms, irrespective of diuretic use or dosing. Dapagliflozin reduced new initiation of loop diuretics by 32% [hazard ratio (HR) 0.68; 95% confidence interval (CI): 0.55\u20130.84, P &amp;lt; 0.001] but did not influence discontinuations\/disruptions (HR 0.98; 95% CI: 0.86\u20131.13, P = 0.83) in follow-up. First sustained loop diuretic dose increases were less frequent, and sustained dose decreases were more frequent in patients treated with dapagliflozin: net difference of \u22126.5% (95% CI: \u22129.4 to \u22123.6; P &amp;lt; 0.001). The mean dose of loop diuretic increased over time in the placebo arm, a longitudinal increase that was significantly attenuated with treatment with dapagliflozin (placebo-corrected treatment effect of \u22122.5 mg\/year; 95% CI: \u22121.5, \u22123.7, P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with heart failure with mildly reduced or preserved ejection fraction, the clinical benefits of dapagliflozin relative to placebo were consistent across a wide range of diuretic categories and doses with a similar safety profile. Treatment with dapagliflozin significantly reduced new loop diuretic requirement over time.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehad283","type":"journal-article","created":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T17:21:57Z","timestamp":1684862517000},"page":"2930-2943","source":"Crossref","is-referenced-by-count":53,"title":["Dapagliflozin and diuretic utilization in heart failure with mildly reduced or preserved ejection fraction: the DELIVER trial"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0082-8649","authenticated-orcid":false,"given":"Safia","family":"Chatur","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School , 75 Francis Street, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-1953","authenticated-orcid":false,"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School , 75 Francis Street, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Claggett","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School , 75 Francis Street, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6387-1351","authenticated-orcid":false,"given":"Orly","family":"Vardeny","sequence":"additional","affiliation":[{"name":"Minneapolis VA Center for Care Delivery and Outcomes Research, University of Minnesota , Minneapolis, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1443-0701","authenticated-orcid":false,"given":"Akshay S","family":"Desai","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School , 75 Francis Street, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pardeep S","family":"Jhund","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, University of Glasgow , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf A","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Erasmus Medical Center , Rotterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn S P","family":"Lam","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore & Duke-National University of Singapore , Singapore , Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail N","family":"Kosiborod","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute and University of Missouri-Kansas City , Kansas City, MO , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiv J","family":"Shah","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Martinez","sequence":"additional","affiliation":[{"name":"Universidad Nacional de C\u00f3rdoba , C\u00f3rdoba , Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio E","family":"Inzucchi","sequence":"additional","affiliation":[{"name":"Yale School of Medicine , New Haven, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian F","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke University Medical Center , Durham, NC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Haddad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Virginia Heart , Falls Church, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeet S","family":"Mitter","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-1444","authenticated-orcid":false,"given":"Zi Michael","family":"Miao","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital, Harvard Medical School , 75 Francis Street, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Petersson","sequence":"additional","affiliation":[{"name":"Late-Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Maria Langkilde","sequence":"additional","affiliation":[{"name":"Late-Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J V","family":"McMurray","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, University of Glasgow , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-9597","authenticated-orcid":false,"given":"Scott D","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, 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