In this short presentation on behalf of the investigators, Dr Mikhail Kosiborod (St Luke’s Mid America Heart Institute), summarises the PRESERVED-HF study.

HFpEF is still the biggest unmet need in heart failure practice. Whilst SGLT-2 inhibitors have showed promising effects in HFpEF patients in some of the large diabetes CVOTs,^1,2 until the publication of EMPEROR-PRESERVED³ no agent has been able to demonstrate significant reductions in death and hospitalisations in this population. With the forthcoming DELIVER trial (NCT03619213) now highly anticipated, it is hoped that the HFpEF population will soon have multiple treatment options to improve these clinical outcomes. 

Another important goal of treatment is to enable patients to live without symptom burden or physical limitations and to experience good quality of life. In all studies to date, this element of SGLT-2 inhibitor treatment has remained undetermined. Recently however, the PRESERVED-HF study – an investigator-led, multicentre study across 26 sites in the US showed, for the first time, that dapagliflozin leads to significant improvement in both symptoms and physical limitation in HFpEF patients.⁴ Moreover, the median ejection fraction in this study population was 60% – well within the revised definition of HFpEF.⁵ 

As such, in lieu of specific guideline recommendations on the use of SGLT-2 inhibitors in HFpEF patients, it will be of relevance for prescribers to have access to this data when addressing the symptom and physical limitations of their patients. We propose a presentation of the main data, together with a series of short peer-to-peer videos, to disseminate this potentially, practice-changing data. 

Learning Objectives

• Recall the symptom and physical limitation improvements achieved in PRESERVED-HF

• Describe the characteristics of the PRESERVED-HF study patient population in the context of real-world patients

• Discuss the potential clinical implications of PRESERVED-HF to the treatment of patients with HFpEF

References

1. Figtree GA, Rådholm K, Barrett TD, et al. Circulation. 2019 May 28; 139(22):2591-2593. 

2. Kato ET, Silverman MG, Mosenzon O, et al. Circulation. 2019 May 28; 139(22):2528-2536. 

3. Anker S, Butler J, Filippatos G, et al. N Engl J Med. 2021;Epub ahead of print. 

4. PRESERVED-HF investigators. Press release expected 12 September 2021. 

5. McDonagh T, et al. Eur Heart J. 2021 Aug 27;ehab368. Online ahead of print.