Dapagliflozin reduces the risk for hyperkalemia in patients with heart failure and reduced ejection fraction (HFrEF) taking mineralocorticoid receptor antagonists (MRAs), according to new study findings presented at the European Society of Cardiology virtual congress.

In a secondary analysis of the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure (DAPA-HF) trial, 3370 (70.1%) patients were treated with an MRA. Mild hyperkalemia (serum potassium more than 5.5 mmol/L) and moderate-to-severe hyperkalemia (more than 6.0 mmol/L) occurred in 182 (11.1%) and 23 (1.4%) patients treated with dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, compared with 204 (12.6%) and 40 (2.4%) of patients receiving placebo, respectively. Dapagliflozin reduced the risk for mild hyperkalemia by 14% and moderate-to-severe hyperkalemia by 50% (P =.01) compared with placebo, Søren Lund Kristensen, MD, PhD, of Copenhagen University Hospital, Copenhagen, Denmark, reported. The incidence of moderate-to-severe hyperkalemia was reduced from 1.7 to 1.0 per 100 person-years with dapagliflozin.

This clinical trial was supported by AstraZeneca. Please see the original reference for a full list of authors’ disclosures.

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Kristensen SL, Docherty KF, Jhund PS, et al. Dapagliflozin reduces the risk of hyperkalaemia in patients with heart failure and reduced ejection fraction: a secondary analysis DAPA-HF. Presented at ESC Virtual Congress 2020, August 29, 2020.