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Dapagliflozin for helping ejection fraction?

MR. BMJ

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I'm not educated with this drug, but was reading the study listed below on how it can help with heart failure patients suffering from reduced ejection fractions. Would this compound be beneficial for bodybuilders in any capacity who are blasting and cruising, or let's say somebody who uses test most of the year, then wants to step on the gas for cutting (or a yearly bulk)? Would adding it in during the pushing the gas part be of any benefit?

This may be way off, but I figured i'd run it by the folks here, this is not my area. I have no idea of it's availability or side effects either, so forgive my ignorance on all that because like I mentioned above, I have not researched it at all.


February 17, 2021

Time to Clinical Benefit of Dapagliflozin and Significance of Prior Heart Failure Hospitalization in Patients With Heart Failure With Reduced Ejection Fraction​

David D. Berg, MD, MPH1; Pardeep S. Jhund, MBChB, MSc, PhD2; Kieran F. Docherty, MBChB2; et alSabina A. Murphy, MPH1; Subodh Verma, MD, PhD3; Silvio E. Inzucchi, MD4; Lars Køber, MD, DMSc5; Mikhail N. Kosiborod, MD6; Anna Maria Langkilde, MD, PhD7; Felipe A. Martinez, MD8; Olof Bengtsson, PhLic7; Piotr Ponikowski, MD, PhD9; Mikaela Sjöstrand, MD, PhD7; Scott D. Solomon, MD10; John J. V. McMurray, MD2; Marc S. Sabatine, MD, MPH1
Author Affiliations

JAMA Cardiol. Published online February 17, 2021. doi:10.1001/jamacardio.2020.7585

Question When does the clinical benefit of dapagliflozin emerge in patients with heart failure with reduced ejection fraction, and what is the magnitude as a function of proximity to prior heart failure hospitalization?

Findings In this secondary analysis of a randomized clinical trial, dapagliflozin rapidly reduced the risk of cardiovascular death or worsening heart failure, with a sustained statistically significant benefit as soon as 28 days. Patients with a more recent heart failure hospitalization were at particularly high risk and experienced robust relative and absolute risk reductions.

Meaning In this study, there was a rapid reduction in risk of cardiovascular death or worsening heart failure when dapagliflozin was initiated in patients with heart failure with reduced ejection fraction, with particularly large absolute risk reductions in patients with a more recent heart failure hospitalization.

Abstract
Importance Dapagliflozin has been shown to reduce the risk of cardiovascular death or worsening heart failure (HF) in patients with chronic HF and reduced ejection fraction (HFrEF). However, clinical inertia often underlies deferred initiation of effective therapies.

Objective To examine timing of onset of clinical benefit with dapagliflozin and magnitude as a function of proximity to prior HF hospitalization.

Design, Setting, and Participants This is a secondary analysis of a completed multinational trial. The Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure trial was a double-blind, placebo-controlled randomized clinical trial of dapagliflozin in patients with chronic HFrEF (n = 4744). From February 2017 to August 2018, the study enrolled patients in New York Heart Association classes II through IV and with left ventricular ejection fraction of 40% or less; the median (range) follow-up time was 18.2 (0-27.8) months. Hazard ratios (HRs) were calculated for the primary efficacy outcome with dapagliflozin vs placebo by time following randomization. Efficacy and safety of dapagliflozin were assessed according to the timing of the most recent HF hospitalization prior to trial enrollment.

Exposures None.

Main Outcomes and Measures Composite of cardiovascular death or worsening HF.

Results A total of 4744 patients were included (1109 women [23.4%]; mean [SD] age, 66.3 [10.9] years). The reduction in the primary outcome with dapagliflozin was rapidly apparent, with a sustained statistically significant benefit by 28 days after randomization (HR at 28 days, 0.51 [95% CI, 0.28-0.94]; P = .03). A total of 2251 patients (47.4%) had been previously hospitalized for HF, and 1301 (27.4%) had been hospitalized within 12 months prior to enrollment. Among patients treated with placebo, there was a stepwise gradient of risk for the primary outcome according to timing of most recent HF hospitalization, with 2-year Kaplan-Meier rates of 21.1%, 25.3%, and 33.8% (adjusted P = .003) for patients with a prior HF hospitalization never, more than 12 months ago, and 12 or fewer months ago, respectively. Across these subgroups, dapagliflozin reduced the relative risk of the primary outcome by 16% (HR, 0.84 [95% CI, 0.69-1.01]), 27% (HR, 0.73 [95% CI, 0.54-0.99]), and 36% (HR, 0.64 [95% CI, 0.51-0.80]), respectively (P = .07 for trend). Accordingly, patients with a more recent HF hospitalization tended to experience greater absolute risk reductions with dapagliflozin at 2 years: 2.1% (95% CI, −1.9% to 6.1%), 4.1% (95% CI, −3.6% to 11.7%), and 9.9% (95% CI, 3.3%-16.5%), respectively (P = .05 for trend).

Conclusions and Relevance In this study, treatment with dapagliflozin was associated with rapid reduction in the risk of cardiovascular death or worsening HF, with a sustained statistically significant benefit emerging very early after randomization. Patients with a more recent HF hospitalization were at particularly high risk and experienced greater relative and absolute risk reductions with dapagliflozin.
 

nothuman

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We need more posts like this. Thanks for sharing.

Empagiflozin, a similar drug, is also being studied for the same benefits with the same positive outcomes so far. I tried it myself but it jacked up my Hemoglobin (which studies have shown it can do) so I dropped it for the time being. I noticed it lowers A1C (no surprise because it's a diabetes drug but mine is already borderline too low) and uric acid levels based on my labs.
 

MR. BMJ

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We need more posts like this. Thanks for sharing.

Empagiflozin, a similar drug, is also being studied for the same benefits with the same positive outcomes so far. I tried it myself but it jacked up my Hemoglobin (which studies have shown it can do) so I dropped it for the time being. I noticed it lowers A1C (no surprise because it's a diabetes drug but mine is already borderline too low) and uric acid levels based on my labs.

Thanks man! Hopefully some others can post their thoughts on this, or other similar (or different) drugs that are out there. When I get some time i'll have to look into it. I posted it because I came across it the other day, and may not get around to looking into it for....i'm not sure how long. If it's something that can be incorporated during certain times when we press on the gas, i'm hoping it can be of use or be beneficial. It may not be practical, or be black/white, but that's why I posted it to see what others thought:cool:
 

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