Groundbreaking Dapagliflozin Study Shows Promise for Elderly Heart Failure Patients Undergoing Valve Replacement!

In a landmark study, dapagliflozin (Farxiga; AstraZeneca), a sodium-glucose cotransporter-2 (SGLT2) inhibitor, has emerged as a safe and effective treatment for older adults with heart failure undergoing transcatheter aortic valve replacement (TAVR). This exciting trial is the first of its kind to investigate the effects of SGLT2 inhibitors specifically in patients with valvular heart disease.

Presented at the American College of Cardiology 2025 Scientific Session, the DapaTAVI trial found that patients treated with dapagliflozin post-TAVR had a staggering 28% lower risk of death or worsening heart failure within one year compared to those not receiving the drug. This breakthrough is significant, as it highlights the potential of SGLT2 inhibitors in preventing adverse outcomes in this high-risk population.

The study involved 1,257 participants aged approximately 82 years old, all of whom had previously been hospitalized for heart failure due to severe aortic stenosis and were at high risk for poor health outcomes due to conditions such as diabetes and renal dysfunction. Half of the participants received dapagliflozin starting within two weeks post-procedure, while the other half did not.

Importantly, patients receiving dapagliflozin demonstrated a remarkable 37% reduction in the occurrence of worsening heart failure. While there was no significant difference in all-cause mortality between groups, the findings underscore the drug's potential to improve quality of life and clinical outcomes for elderly patients facing serious heart conditions.

Dr. Sergio Raposeiras-Roubin, the study's lead author, expressed the significance of these results: "Our study indicates that for patients undergoing TAVI who are at risk of heart failure, initiating treatment with dapagliflozin is crucial. These drugs are safe and offer numerous benefits."

While adverse events were relatively common due to the participants' age and pre-existing health issues, the safety profile of dapagliflozin remained encouraging. Instances of low blood pressure and certain infections were reported, but rates of urinary tract infections—often linked to SGLT2 inhibitors—did not significantly differ between the two groups.

The implications of this research are profound. The DapaTAVI trial not only provides vital evidence supporting the use of SGLT2 inhibitors in a demographic often excluded from clinical studies but also strengthens the scientific foundation for treating elderly heart patients. The research team is set to explore further the impact on different subgroups based on left ventricle ejection fraction and assess quality of life outcomes in future studies.

With the increasing prevalence of heart disease among older adults, these findings pave the way for critical advancements in cardiovascular treatment strategies. As the medical community continues to seek innovative ways to enhance patient outcomes, dapagliflozin may soon become a cornerstone in the management of heart failure in elderly patients, representing hope for millions.