Coronary flow reserve increase after 4-year dapagliflozin treatment in patients with type 2 diabetes: the DAPAHEART follow-up study
Authors' conclusion
The 30% CFR improvement seen after 4 weeks of dapagliflozin persisted at 4 years, together with a significant reduction in EAT thickness, possibly explaining CFR improvement. Similar results in the placebo group after treatment strongly support a causal relationship and underscore the long-term CV benefits of dapagliflozin and its role in reducing CV risk in T2DM patients.
Study context
- Population
- Patients with T2D and stable coronary artery disease
- Comparison
- Dapagliflozin long-term vs baseline
- Primary endpoint
- CFR and EAT thickness measured by 13N-ammonia PET/CT
- Follow-up
- 4 years
Methodological detailspilot study, single-centre, original trial randomized 1:1, double-blind, placebo-controlled, placebo patients transitioned to dapagliflozin
- Pilot study
- Single-centre
- Original trial randomized 1:1, double-blind, placebo-controlled
- Placebo patients transitioned to dapagliflozin
Primary result
As reported in the abstract
CFR
- Coronary flow reserve (CFR) increase after 4 years
- 34.4%
- CFR baseline (mean ± SD)
- 2.15 ± 0.19
- CFR at 4 years (mean ± SD)
- 2.85 ± 0.26
- P for change in CFR
- p = 0.001
- Epicardial adipose tissue (EAT) thickness reduction
- 29.18%
- P for change in EAT thickness
- p = 0.03
Further findings
BMI · 4 years
- BMI decreased in all patients
- P = 0.001
- Changes in BMI and EAT thickness not significantly correlated
- R2 = 0.0662; p = 0.5
Original publication
Coronary flow reserve increase after 4-year dapagliflozin treatment in patients with type 2 diabetes: the DAPAHEART follow-up study. Cardiovasc Diabetol. Published 31 August 2025. doi:10.
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