Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Polypharmacy Status
Patients with heart failure (HF) have a high burden of multimorbidity, often necessitating numerous medications. There may be clinical concern about introducing another medication, especially among individuals with polypharmacy. This study examined the efficacy and safety of addition of dapagliflozi...
Gespeichert in:
| Veröffentlicht in: | JACC. Heart failure 2023-10, Vol.11 (10), p.1380-1393 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1393 |
|---|---|
| container_issue | 10 |
| container_start_page | 1380 |
| container_title | JACC. Heart failure |
| container_volume | 11 |
| creator | Peikert, Alexander Goyal, Parag Vaduganathan, Muthiah Claggett, Brian L. Kulac, Ian J. Miao, Zi Michael Vardeny, Orly Kosiborod, Mikhail N. Desai, Akshay S. Jhund, Pardeep S. Lam, Carolyn S.P. Inzucchi, Silvio E. Martinez, Felipe A. de Boer, Rudolf A. Hernandez, Adrian F. Shah, Sanjiv J. Petersson, Magnus Langkilde, Anna Maria McMurray, John J.V. Solomon, Scott D. |
| description | Patients with heart failure (HF) have a high burden of multimorbidity, often necessitating numerous medications. There may be clinical concern about introducing another medication, especially among individuals with polypharmacy.
This study examined the efficacy and safety of addition of dapagliflozin according to the number of concomitant medications in HF with mildly reduced or preserved ejection fraction.
In this post hoc analysis of the DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure) trial, 6,263 participants with symptomatic HF with left ventricular ejection fraction >40% were randomized to dapagliflozin or placebo. Baseline medication use (including vitamins and supplements) was collected. Efficacy and safety outcomes were assessed by medication use categories (“nonpolypharmacy”: |
| doi_str_mv | 10.1016/j.jchf.2023.05.014 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2824685557</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2213177923002500</els_id><sourcerecordid>2824685557</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-4b1b3c17483216164973a5c3aafabcb268cd96a772fee4f259ddbfb36c0458623</originalsourceid><addsrcrecordid>eNp9kE1qHDEQhUVIiI3jC2QRtMxmOvptqSEb49hxwCEmP2Qp1FK1R42mNZG6DZPT-Cw-WTQZx8sUBVUF7z2oD6HXlDSU0Pbd2IxuPTSMMN4Q2RAqnqFjxihfUaXV86dddUfotJSR1NKSaq1foiOuWCeYEMdo-WC39jaGIabfYcK1r8Dm-eH-0oa4ZMA_w7zGn0P0cfdw_xX84sDjlPFNhgL5rh4XI7g5pKl6sv274TPnUvZhusVzwjcp7rZrmzfW7fC32c5LeYVeDDYWOH2cJ-jH5cX386vV9ZePn87PrldOEDKvRE977qgSmjPa0lZ0ilvpuLWD7V3PWu1811ql2AAgBiY77_uh560jQuqW8RP09pC7zenXAmU2m1AcxGgnSEsxTDPRaimlqlJ2kLqcSskwmG0OG5t3hhKzJ25Gsydu9sQNkaYSr6Y3j_lLvwH_ZPnHtwreHwRQv7wLkE1xAabKMORKzfgU_pf_B31ulXw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2824685557</pqid></control><display><type>article</type><title>Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Polypharmacy Status</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Peikert, Alexander ; Goyal, Parag ; Vaduganathan, Muthiah ; Claggett, Brian L. ; Kulac, Ian J. ; Miao, Zi Michael ; Vardeny, Orly ; Kosiborod, Mikhail N. ; Desai, Akshay S. ; Jhund, Pardeep S. ; Lam, Carolyn S.P. ; Inzucchi, Silvio E. ; Martinez, Felipe A. ; de Boer, Rudolf A. ; Hernandez, Adrian F. ; Shah, Sanjiv J. ; Petersson, Magnus ; Langkilde, Anna Maria ; McMurray, John J.V. ; Solomon, Scott D.</creator><creatorcontrib>Peikert, Alexander ; Goyal, Parag ; Vaduganathan, Muthiah ; Claggett, Brian L. ; Kulac, Ian J. ; Miao, Zi Michael ; Vardeny, Orly ; Kosiborod, Mikhail N. ; Desai, Akshay S. ; Jhund, Pardeep S. ; Lam, Carolyn S.P. ; Inzucchi, Silvio E. ; Martinez, Felipe A. ; de Boer, Rudolf A. ; Hernandez, Adrian F. ; Shah, Sanjiv J. ; Petersson, Magnus ; Langkilde, Anna Maria ; McMurray, John J.V. ; Solomon, Scott D.</creatorcontrib><description>Patients with heart failure (HF) have a high burden of multimorbidity, often necessitating numerous medications. There may be clinical concern about introducing another medication, especially among individuals with polypharmacy.
This study examined the efficacy and safety of addition of dapagliflozin according to the number of concomitant medications in HF with mildly reduced or preserved ejection fraction.
In this post hoc analysis of the DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure) trial, 6,263 participants with symptomatic HF with left ventricular ejection fraction >40% were randomized to dapagliflozin or placebo. Baseline medication use (including vitamins and supplements) was collected. Efficacy and safety outcomes were assessed by medication use categories (“nonpolypharmacy”: <5 medications; “polypharmacy”: 5 to 9 medications; and “hyperpolypharmacy”: ≥10 medications) and continuously. The primary outcome was worsening HF or cardiovascular death.
Overall, 3,795 (60.6%) patients met polypharmacy and 1,886 (30.1%) met hyperpolypharmacy criteria. Higher numbers of medications were strongly associated with higher comorbidity burden and increased rates of the primary outcome. Compared with placebo, dapagliflozin similarly reduced the risk of the primary outcome irrespective of polypharmacy status (nonpolypharmacy HR: 0.88 [95% CI: 0.58-1.34]; polypharmacy HR: 0.88 [95% CI: 0.75-1.03]; hyperpolypharmacy HR: 0.73 [95% CI: 0.60-0.88]; Pinteraction = 0.30). Similarly, benefits with dapagliflozin were consistent across the spectrum of total medication use (Pinteraction = 0.06). Although adverse events increased with higher number of medications, they were not more frequent with dapagliflozin, regardless of polypharmacy status.
In the DELIVER trial, dapagliflozin safely reduced worsening HF or cardiovascular death across a broad range of baseline medication use, including among individuals with polypharmacy (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure [DELIVER]; NCT03619213)
[Display omitted]</description><identifier>ISSN: 2213-1779</identifier><identifier>EISSN: 2213-1787</identifier><identifier>DOI: 10.1016/j.jchf.2023.05.014</identifier><identifier>PMID: 37294244</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Heart Failure - drug therapy ; heart failure with mildly reduced ejection fraction ; heart failure with preserved ejection fraction ; Heart Failure, Diastolic ; Humans ; Polypharmacy ; SGLT2 inhibitors ; Stroke Volume ; Ventricular Function, Left</subject><ispartof>JACC. Heart failure, 2023-10, Vol.11 (10), p.1380-1393</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-4b1b3c17483216164973a5c3aafabcb268cd96a772fee4f259ddbfb36c0458623</citedby><cites>FETCH-LOGICAL-c400t-4b1b3c17483216164973a5c3aafabcb268cd96a772fee4f259ddbfb36c0458623</cites><orcidid>0000-0001-7474-3737 ; 0000-0002-6317-3975 ; 0000-0002-4775-9140 ; 0000-0003-0947-5865</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37294244$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peikert, Alexander</creatorcontrib><creatorcontrib>Goyal, Parag</creatorcontrib><creatorcontrib>Vaduganathan, Muthiah</creatorcontrib><creatorcontrib>Claggett, Brian L.</creatorcontrib><creatorcontrib>Kulac, Ian J.</creatorcontrib><creatorcontrib>Miao, Zi Michael</creatorcontrib><creatorcontrib>Vardeny, Orly</creatorcontrib><creatorcontrib>Kosiborod, Mikhail N.</creatorcontrib><creatorcontrib>Desai, Akshay S.</creatorcontrib><creatorcontrib>Jhund, Pardeep S.</creatorcontrib><creatorcontrib>Lam, Carolyn S.P.</creatorcontrib><creatorcontrib>Inzucchi, Silvio E.</creatorcontrib><creatorcontrib>Martinez, Felipe A.</creatorcontrib><creatorcontrib>de Boer, Rudolf A.</creatorcontrib><creatorcontrib>Hernandez, Adrian F.</creatorcontrib><creatorcontrib>Shah, Sanjiv J.</creatorcontrib><creatorcontrib>Petersson, Magnus</creatorcontrib><creatorcontrib>Langkilde, Anna Maria</creatorcontrib><creatorcontrib>McMurray, John J.V.</creatorcontrib><creatorcontrib>Solomon, Scott D.</creatorcontrib><title>Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Polypharmacy Status</title><title>JACC. Heart failure</title><addtitle>JACC Heart Fail</addtitle><description>Patients with heart failure (HF) have a high burden of multimorbidity, often necessitating numerous medications. There may be clinical concern about introducing another medication, especially among individuals with polypharmacy.
This study examined the efficacy and safety of addition of dapagliflozin according to the number of concomitant medications in HF with mildly reduced or preserved ejection fraction.
In this post hoc analysis of the DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure) trial, 6,263 participants with symptomatic HF with left ventricular ejection fraction >40% were randomized to dapagliflozin or placebo. Baseline medication use (including vitamins and supplements) was collected. Efficacy and safety outcomes were assessed by medication use categories (“nonpolypharmacy”: <5 medications; “polypharmacy”: 5 to 9 medications; and “hyperpolypharmacy”: ≥10 medications) and continuously. The primary outcome was worsening HF or cardiovascular death.
Overall, 3,795 (60.6%) patients met polypharmacy and 1,886 (30.1%) met hyperpolypharmacy criteria. Higher numbers of medications were strongly associated with higher comorbidity burden and increased rates of the primary outcome. Compared with placebo, dapagliflozin similarly reduced the risk of the primary outcome irrespective of polypharmacy status (nonpolypharmacy HR: 0.88 [95% CI: 0.58-1.34]; polypharmacy HR: 0.88 [95% CI: 0.75-1.03]; hyperpolypharmacy HR: 0.73 [95% CI: 0.60-0.88]; Pinteraction = 0.30). Similarly, benefits with dapagliflozin were consistent across the spectrum of total medication use (Pinteraction = 0.06). Although adverse events increased with higher number of medications, they were not more frequent with dapagliflozin, regardless of polypharmacy status.
In the DELIVER trial, dapagliflozin safely reduced worsening HF or cardiovascular death across a broad range of baseline medication use, including among individuals with polypharmacy (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure [DELIVER]; NCT03619213)
[Display omitted]</description><subject>Heart Failure - drug therapy</subject><subject>heart failure with mildly reduced ejection fraction</subject><subject>heart failure with preserved ejection fraction</subject><subject>Heart Failure, Diastolic</subject><subject>Humans</subject><subject>Polypharmacy</subject><subject>SGLT2 inhibitors</subject><subject>Stroke Volume</subject><subject>Ventricular Function, Left</subject><issn>2213-1779</issn><issn>2213-1787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1qHDEQhUVIiI3jC2QRtMxmOvptqSEb49hxwCEmP2Qp1FK1R42mNZG6DZPT-Cw-WTQZx8sUBVUF7z2oD6HXlDSU0Pbd2IxuPTSMMN4Q2RAqnqFjxihfUaXV86dddUfotJSR1NKSaq1foiOuWCeYEMdo-WC39jaGIabfYcK1r8Dm-eH-0oa4ZMA_w7zGn0P0cfdw_xX84sDjlPFNhgL5rh4XI7g5pKl6sv274TPnUvZhusVzwjcp7rZrmzfW7fC32c5LeYVeDDYWOH2cJ-jH5cX386vV9ZePn87PrldOEDKvRE977qgSmjPa0lZ0ilvpuLWD7V3PWu1811ql2AAgBiY77_uh560jQuqW8RP09pC7zenXAmU2m1AcxGgnSEsxTDPRaimlqlJ2kLqcSskwmG0OG5t3hhKzJ25Gsydu9sQNkaYSr6Y3j_lLvwH_ZPnHtwreHwRQv7wLkE1xAabKMORKzfgU_pf_B31ulXw</recordid><startdate>202310</startdate><enddate>202310</enddate><creator>Peikert, Alexander</creator><creator>Goyal, Parag</creator><creator>Vaduganathan, Muthiah</creator><creator>Claggett, Brian L.</creator><creator>Kulac, Ian J.</creator><creator>Miao, Zi Michael</creator><creator>Vardeny, Orly</creator><creator>Kosiborod, Mikhail N.</creator><creator>Desai, Akshay S.</creator><creator>Jhund, Pardeep S.</creator><creator>Lam, Carolyn S.P.</creator><creator>Inzucchi, Silvio E.</creator><creator>Martinez, Felipe A.</creator><creator>de Boer, Rudolf A.</creator><creator>Hernandez, Adrian F.</creator><creator>Shah, Sanjiv J.</creator><creator>Petersson, Magnus</creator><creator>Langkilde, Anna Maria</creator><creator>McMurray, John J.V.</creator><creator>Solomon, Scott D.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7474-3737</orcidid><orcidid>https://orcid.org/0000-0002-6317-3975</orcidid><orcidid>https://orcid.org/0000-0002-4775-9140</orcidid><orcidid>https://orcid.org/0000-0003-0947-5865</orcidid></search><sort><creationdate>202310</creationdate><title>Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Polypharmacy Status</title><author>Peikert, Alexander ; Goyal, Parag ; Vaduganathan, Muthiah ; Claggett, Brian L. ; Kulac, Ian J. ; Miao, Zi Michael ; Vardeny, Orly ; Kosiborod, Mikhail N. ; Desai, Akshay S. ; Jhund, Pardeep S. ; Lam, Carolyn S.P. ; Inzucchi, Silvio E. ; Martinez, Felipe A. ; de Boer, Rudolf A. ; Hernandez, Adrian F. ; Shah, Sanjiv J. ; Petersson, Magnus ; Langkilde, Anna Maria ; McMurray, John J.V. ; Solomon, Scott D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-4b1b3c17483216164973a5c3aafabcb268cd96a772fee4f259ddbfb36c0458623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Heart Failure - drug therapy</topic><topic>heart failure with mildly reduced ejection fraction</topic><topic>heart failure with preserved ejection fraction</topic><topic>Heart Failure, Diastolic</topic><topic>Humans</topic><topic>Polypharmacy</topic><topic>SGLT2 inhibitors</topic><topic>Stroke Volume</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peikert, Alexander</creatorcontrib><creatorcontrib>Goyal, Parag</creatorcontrib><creatorcontrib>Vaduganathan, Muthiah</creatorcontrib><creatorcontrib>Claggett, Brian L.</creatorcontrib><creatorcontrib>Kulac, Ian J.</creatorcontrib><creatorcontrib>Miao, Zi Michael</creatorcontrib><creatorcontrib>Vardeny, Orly</creatorcontrib><creatorcontrib>Kosiborod, Mikhail N.</creatorcontrib><creatorcontrib>Desai, Akshay S.</creatorcontrib><creatorcontrib>Jhund, Pardeep S.</creatorcontrib><creatorcontrib>Lam, Carolyn S.P.</creatorcontrib><creatorcontrib>Inzucchi, Silvio E.</creatorcontrib><creatorcontrib>Martinez, Felipe A.</creatorcontrib><creatorcontrib>de Boer, Rudolf A.</creatorcontrib><creatorcontrib>Hernandez, Adrian F.</creatorcontrib><creatorcontrib>Shah, Sanjiv J.</creatorcontrib><creatorcontrib>Petersson, Magnus</creatorcontrib><creatorcontrib>Langkilde, Anna Maria</creatorcontrib><creatorcontrib>McMurray, John J.V.</creatorcontrib><creatorcontrib>Solomon, Scott D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peikert, Alexander</au><au>Goyal, Parag</au><au>Vaduganathan, Muthiah</au><au>Claggett, Brian L.</au><au>Kulac, Ian J.</au><au>Miao, Zi Michael</au><au>Vardeny, Orly</au><au>Kosiborod, Mikhail N.</au><au>Desai, Akshay S.</au><au>Jhund, Pardeep S.</au><au>Lam, Carolyn S.P.</au><au>Inzucchi, Silvio E.</au><au>Martinez, Felipe A.</au><au>de Boer, Rudolf A.</au><au>Hernandez, Adrian F.</au><au>Shah, Sanjiv J.</au><au>Petersson, Magnus</au><au>Langkilde, Anna Maria</au><au>McMurray, John J.V.</au><au>Solomon, Scott D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Polypharmacy Status</atitle><jtitle>JACC. Heart failure</jtitle><addtitle>JACC Heart Fail</addtitle><date>2023-10</date><risdate>2023</risdate><volume>11</volume><issue>10</issue><spage>1380</spage><epage>1393</epage><pages>1380-1393</pages><issn>2213-1779</issn><eissn>2213-1787</eissn><abstract>Patients with heart failure (HF) have a high burden of multimorbidity, often necessitating numerous medications. There may be clinical concern about introducing another medication, especially among individuals with polypharmacy.
This study examined the efficacy and safety of addition of dapagliflozin according to the number of concomitant medications in HF with mildly reduced or preserved ejection fraction.
In this post hoc analysis of the DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure) trial, 6,263 participants with symptomatic HF with left ventricular ejection fraction >40% were randomized to dapagliflozin or placebo. Baseline medication use (including vitamins and supplements) was collected. Efficacy and safety outcomes were assessed by medication use categories (“nonpolypharmacy”: <5 medications; “polypharmacy”: 5 to 9 medications; and “hyperpolypharmacy”: ≥10 medications) and continuously. The primary outcome was worsening HF or cardiovascular death.
Overall, 3,795 (60.6%) patients met polypharmacy and 1,886 (30.1%) met hyperpolypharmacy criteria. Higher numbers of medications were strongly associated with higher comorbidity burden and increased rates of the primary outcome. Compared with placebo, dapagliflozin similarly reduced the risk of the primary outcome irrespective of polypharmacy status (nonpolypharmacy HR: 0.88 [95% CI: 0.58-1.34]; polypharmacy HR: 0.88 [95% CI: 0.75-1.03]; hyperpolypharmacy HR: 0.73 [95% CI: 0.60-0.88]; Pinteraction = 0.30). Similarly, benefits with dapagliflozin were consistent across the spectrum of total medication use (Pinteraction = 0.06). Although adverse events increased with higher number of medications, they were not more frequent with dapagliflozin, regardless of polypharmacy status.
In the DELIVER trial, dapagliflozin safely reduced worsening HF or cardiovascular death across a broad range of baseline medication use, including among individuals with polypharmacy (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure [DELIVER]; NCT03619213)
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37294244</pmid><doi>10.1016/j.jchf.2023.05.014</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0001-7474-3737</orcidid><orcidid>https://orcid.org/0000-0002-6317-3975</orcidid><orcidid>https://orcid.org/0000-0002-4775-9140</orcidid><orcidid>https://orcid.org/0000-0003-0947-5865</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2213-1779 |
| ispartof | JACC. Heart failure, 2023-10, Vol.11 (10), p.1380-1393 |
| issn | 2213-1779 2213-1787 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2824685557 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Heart Failure - drug therapy heart failure with mildly reduced ejection fraction heart failure with preserved ejection fraction Heart Failure, Diastolic Humans Polypharmacy SGLT2 inhibitors Stroke Volume Ventricular Function, Left |
| title | Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction According to Polypharmacy Status |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-18T22%3A43%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Dapagliflozin%20in%20Heart%C2%A0Failure%20With%20Mildly%C2%A0Reduced%20or%20Preserved%20Ejection%C2%A0Fraction%20According%20to%20Polypharmacy%20Status&rft.jtitle=JACC.%20Heart%20failure&rft.au=Peikert,%20Alexander&rft.date=2023-10&rft.volume=11&rft.issue=10&rft.spage=1380&rft.epage=1393&rft.pages=1380-1393&rft.issn=2213-1779&rft.eissn=2213-1787&rft_id=info:doi/10.1016/j.jchf.2023.05.014&rft_dat=%3Cproquest_cross%3E2824685557%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2824685557&rft_id=info:pmid/37294244&rft_els_id=S2213177923002500&rfr_iscdi=true |