Overview
- The Nature Medicine paper published Monday analyzed genome sequencing from 12,685 participants in the DECLARE‑TIMI 58 trial and identified 121 carriers of cardiomyopathy-associated variants.
- Carriers given dapagliflozin had heart-failure hospitalizations fall from 16 percent on placebo to 3 percent on the drug, an about 82 percent relative reduction, while non-carriers saw roughly a 32 percent reduction.
- Lead authors described cardiomyopathy variants as an "actionable genotype" and said the findings support testing to find people who might get an outsized preventive benefit from SGLT2 inhibitors.
- The study’s limits include a small carrier subgroup and that every participant had type 2 diabetes, so researchers say results must be replicated and tested in people without diabetes before changing practice.
- Dapagliflozin is an SGLT2 inhibitor that lowers blood glucose and sodium reabsorption in the kidney and has prior evidence of protecting the heart, which could let clinicians start prevention earlier if follow-up studies confirm these results.