Cardiovasc Drugs Ther. 2026 Jul 1. doi: 10.1007/s10557-026-07904-4. Online ahead of print.
ABSTRACT
PURPOSE: This was a retrospective cohort study. We examined the association between in-hospital dapagliflozin initiation and left ventricular remodeling in revascularized patients with acute myocardial infarction complicated by heart failure.
METHODS: We stratified 266 revascularized AMI patients with heart failure by in-hospital dapagliflozin (10 mg daily) after hemodynamic stabilization. Inverse probability of treatment weighting was used to balance measured baseline covariates. Weighted generalized estimating equations (GEE) tracked changes in LVEDVI over 12 months.
RESULTS: Early dapagliflozin initiation was associated with greater reductions in ventricular volumes. By 12 months, the treatment group exhibited greater reductions in LVEDVI and LVMI (Group × Time interaction P < 0.001), together with better LVEF recovery (56.0% vs. 48.9%). Functional status (NYHA) remained comparable between groups (P = 0.154). Clinically, in-hospital dapagliflozin initiation was associated with a numerical reduction in major adverse cardiovascular events (HR 0.49; 95% CI 0.23-1.04; P = 0.063), mainly attributable to fewer heart failure rehospitalizations.
CONCLUSION: In this retrospective cohort, in-hospital initiation of dapagliflozin was associated with imaging findings suggestive of favorable remodeling and fewer heart failure rehospitalizations. These hypothesis-generating findings warrant confirmation in large-scale randomized controlled trials.
PMID:42384323 | DOI:10.1007/s10557-026-07904-4