Dapagliflozin Effects on Cardiometabolic Outcomes in Patients With an Acute Heart Attack.

NCT ID: NCT04564742

Last Updated: 2025-03-07

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

4017 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-22

Study Completion Date

2023-07-05

Brief Summary

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This study will evaluate the effect of dapagliflozin versus placebo, given once daily in addition to Standard of Care (SoC) therapies for patients with myocardial infarction (MI), for hospitalisation for heart failure (HHF), cardiovascular (CV) death, and other cardiometabolic outcomes.

Detailed Description

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This is a multicentre, parallel group double-blind, placebo-controlled phase 3 registry-based randomised controlled trial (R-RCT) in patients without diabetes presenting with myocardial infarction (MI) (ST segment elevation myocardial infarction (STEMI) or non-ST segment elevation myocardial infarction (NSTEMI)) and evidence of impaired regional or global LV systolic function or definite evidence of Q wave MI on ECG. In the study the effect of dapagliflozin versus placebo, given once daily in addition to SoC therapy will be evaluated for the hospitalisation for HF, CV death, and other cardiometabolic outcomes.

Conditions

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Acute Myocardial Infarction Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Dapagliflozin

Patients will be randomized 1:1 to either dapagliflozin or placebo

Group Type EXPERIMENTAL

Dapagliflozin

Intervention Type DRUG

Dapagliflozin 10 mg tablets given once daily, per oral use

Placebo

Placebo matching dapagliflozin

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo matching dapagliflozin 10 mg tablets given once daily, per oral use

Interventions

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Dapagliflozin

Dapagliflozin 10 mg tablets given once daily, per oral use

Intervention Type DRUG

Placebo

Placebo matching dapagliflozin 10 mg tablets given once daily, per oral use

Intervention Type DRUG

Other Intervention Names

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Forxiga TM Farxiga TM

Eligibility Criteria

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Inclusion Criteria

* Participant must be ≥18 at the time of signing the informed consent
* Confirmed MI, either STEMI or NSTEMI, according to the fourth universal definition of MI (Thygesen et al 2019), within the preceding 7 days, or 10 days if earlier randomisation is not feasible
* Evidence of impaired regional or global LV systolic function at any timepoint during current MI-related hospitalisation (established with echocardiogram, radionuclide ventriculogram, contrast angiography or cardiac MRI) or definitive evidence on ECG of Q wave MI (defined as presence of Q waves in two or more contiguous leads, excluding leads III and aVR, and meeting all the following criteria: at least 1.5 mm in depth; at least 30 ms in duration; and, if R wave present, more than 25% of the size of the subsequent R wave)
* Hemodynamically stable at randomization (no episodes of symptomatic hypotension, or arrhythmia with haemodynamic compromise in the last 24 hours).
* Male or female
* Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in the protocol
* Provision of signed and dated, written informed consent prior to any mandatory study specific procedures, sampling, and analyses

Exclusion Criteria

* Known type 1 diabetes mellitus (T1DM) or T2DM at the time for admission. Patients with hyperglycaemia, but without a diagnosis of diabetes mellitus prior to the index event, are eligible at the discretion of the Investigator. Patients who present with signs and symptoms consistent with ketoacidosis, including nausea, vomiting, abdominal pain, malaise and shortness of breath should be assessed for ketoacidosis, and if ketoacidosis is confirmed the patient should not be randomized.
* Chronic symptomatic HF with a prior HHF within the last year and known reduced ejection fraction (LVEF≤40 %), documented before the current MI hospitalization
* Severe (eGFR \<20 mL/min/1.73 m2 by local laboratory), unstable or rapidly progressing renal disease at the time of randomization
* Severe hepatic impairment (Child-Pugh class C) at the time of inclusion into the trial
* Active malignancy requiring treatment at the time of screening, except for basal cell- or squamous cell carcinoma of the skin, presumed possible to treat successfully
* Any non-CV condition, eg malignancy, with a life expectancy of less than two years based on the investigator´s clinical judgement
* Currently on treatment, or with an indication for treatment, with a sodium glucose co-transporter 2 inhibitor (SGLT2-inhibitor)
Minimum Eligible Age

18 Years

Maximum Eligible Age

130 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Uppsala University

OTHER

Sponsor Role collaborator

AstraZeneca

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stefan James

Role: PRINCIPAL_INVESTIGATOR

Uppsala University

Jonas Oldgren

Role: STUDY_CHAIR

Uppsala University

Locations

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Research Site

Alingsås, , Sweden

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Borås, , Sweden

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Eskilstuna, , Sweden

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Falun, , Sweden

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Gävle, , Sweden

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Gothenburg, , Sweden

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Gothenburg, , Sweden

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Halmstad, , Sweden

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Hässleholm, , Sweden

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Helsingborg, , Sweden

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Jönköping, , Sweden

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Kalix, , Sweden

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Karlshamn, , Sweden

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Karlskoga, , Sweden

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Karlskrona, , Sweden

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Karlstad, , Sweden

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Kiruna, , Sweden

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Köping, , Sweden

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Lidköping, , Sweden

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Linköping, , Sweden

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Lund, , Sweden

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Malmo, , Sweden

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Mölndal, , Sweden

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Norrköping, , Sweden

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Örebro, , Sweden

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Östersund, , Sweden

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Skellefteå, , Sweden

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Stockholm, , Sweden

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Stockholm, , Sweden

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Stockholm, , Sweden

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Stockholm, , Sweden

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Stockholm, , Sweden

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Trollhättan, , Sweden

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Umeå, , Sweden

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Uppsala, , Sweden

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Varberg, , Sweden

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Värnamo, , Sweden

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Västerås, , Sweden

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Ystad, , Sweden

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Aberdeen, , United Kingdom

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Ashford, , United Kingdom

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Basingstoke, , United Kingdom

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Bath, , United Kingdom

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Birmingham, , United Kingdom

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Blackpool, , United Kingdom

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Bradford, , United Kingdom

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Bridgend, , United Kingdom

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Brighton, , United Kingdom

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Bristol, , United Kingdom

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Bristol, , United Kingdom

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Buckhurst Hill, , United Kingdom

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Cambridge, , United Kingdom

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Cardiff, , United Kingdom

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Clydebank, , United Kingdom

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Coventry, , United Kingdom

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Derby, , United Kingdom

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Dundee, , United Kingdom

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East Kilbride, , United Kingdom

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Edgbaston, , United Kingdom

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Edinburgh, , United Kingdom

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Exeter, , United Kingdom

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Gillingham, , United Kingdom

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Glasgow, , United Kingdom

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Harefield, , United Kingdom

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Harrow, , United Kingdom

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Headington, , United Kingdom

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Hull, , United Kingdom

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Kettering, , United Kingdom

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Leeds, , United Kingdom

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Leicester, , United Kingdom

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Lincoln, , United Kingdom

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Liverpool, , United Kingdom

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London, , United Kingdom

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London, , United Kingdom

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London, , United Kingdom

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London, , United Kingdom

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Manchester, , United Kingdom

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Manchester, , United Kingdom

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Merthyr Tydfil, , United Kingdom

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Middlesbrough, , United Kingdom

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Newcastle upon Tyne, , United Kingdom

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Newport, , United Kingdom

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Norwich, , United Kingdom

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Nottingham, , United Kingdom

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Plymouth, , United Kingdom

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Pont-y-clun, , United Kingdom

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Portsmouth, , United Kingdom

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Rhyl, , United Kingdom

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Scarborough, , United Kingdom

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Sheffield, , United Kingdom

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Southampton, , United Kingdom

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Stevenage, , United Kingdom

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Stoke-on-Trent, , United Kingdom

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Sunderland, , United Kingdom

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Swansea, , United Kingdom

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Taunton, , United Kingdom

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Torquay, , United Kingdom

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Truro, , United Kingdom

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Wakefield, , United Kingdom

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Wigan, , United Kingdom

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Wolverhampton, , United Kingdom

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Worcester, , United Kingdom

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Worthing, , United Kingdom

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Countries

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Sweden United Kingdom

References

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James S, Erlinge D, Storey RF, McGuire DK, de Belder M, Eriksson N, Andersen K, Austin D, Arefalk G, Carrick D, Hofmann R, Hoole SP, Jones DA, Lee K, Tygesen H, Johansson PA, Langkilde AM, Ridderstrale W, Parvaresh Rizi E, Deanfield J, Oldgren J. Dapagliflozin in Myocardial Infarction without Diabetes or Heart Failure. NEJM Evid. 2024 Feb;3(2):EVIDoa2300286. doi: 10.1056/EVIDoa2300286. Epub 2023 Nov 11.

Reference Type DERIVED
PMID: 38320489 (View on PubMed)

James S, Erlinge D, Storey RF, McGuire DK, de Belder M, Bjorkgren I, Johansson PA, Langkilde AM, Ridderstrale W, Parvaresh Rizi E, Deanfield J, Oldgren J. Rationale and design of the DAPA-MI trial: Dapagliflozin in patients without diabetes mellitus with acute myocardial infarction. Am Heart J. 2023 Dec;266:188-197. doi: 10.1016/j.ahj.2023.08.008. Epub 2023 Aug 28.

Reference Type DERIVED
PMID: 37648579 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2020-000664-31

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

D169DC00001

Identifier Type: -

Identifier Source: org_study_id

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