DAPA-HF evaluated dapagliflozin in symptomatic heart failure with reduced ejection fraction. The result that changed practice was:

• A Benefit was confined to patients who also had type 2 diabetes mellitus
• B Dapagliflozin improved symptoms without reducing hard endpoints
• C Dapagliflozin reduced cardiovascular death and worsening heart failure whether or not the patient had diabetes ✓
• D Dapagliflozin increased the risk of diabetic ketoacidosis so severely that the trial was halted

Explanation

DAPA-HF enrolled patients with HFrEF on guideline-directed therapy, roughly half without diabetes. Dapagliflozin significantly reduced the composite of worsening heart failure or cardiovascular death, with consistent benefit in diabetic and non-diabetic subgroups. This established SGLT2 inhibitors as foundational therapy for HFrEF independent of glycemic status. Option A is the classic wrong answer because subgroup analysis explicitly showed no interaction with diabetes status.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.