A new study suggests that the diabetes drug dapagliflozin may significantly reduce the risk of heart failure in individuals with specific genetic variants associated with cardiomyopathy.
A recent study published in Nature Medicine has revealed that dapagliflozin, a medication commonly used to treat type 2 diabetes, may help prevent heart failure in patients with genetic variants linked to cardiomyopathy, a progressive disease affecting the heart muscle.
Researchers from Harvard Medical School, Mass General Brigham, and MIT conducted the study using data from the DECLARE-TIMI 58 trial, which involved over 12,000 adults diagnosed with type 2 diabetes and at heightened risk for cardiovascular issues.
Among the participants, approximately 121 individuals carried inherited gene variants that could increase their likelihood of developing cardiomyopathy. The findings indicated that after a median follow-up of 4.2 years, dapagliflozin significantly reduced hospitalizations for heart failure among those with the genetic variants compared to those without.
While dapagliflozin was effective in lowering heart failure hospitalizations in both groups, the reduction was approximately eight times more pronounced in carriers of the genetic variant. Specifically, among the 82% of carriers without a prior history of heart failure, 12.8% in the placebo group developed heart failure, whereas no heart-failure events were reported among those receiving dapagliflozin.
Co-lead study author Dr. Shinwan Kany, a visiting scientist at the Cardiovascular Research Center with Mass General Brigham Heart and Vascular Institute and the Broad Institute, emphasized the implications of these findings for preventive care. “Historically, identifying a genetic variant for cardiomyopathy mostly meant telling a patient they were at high risk and not having a specific preventive therapy to offer,” he stated in a press release. “These data show we do have tools to lower risk in these individuals.”
Experts caution that while the results are promising, they require further validation due to the limited sample size of carriers in the study. Dr. Andrew Freeman, a cardiologist at National Jewish Health who was not involved in the research, described the findings as “important and provocative.” He noted that participants without a history of heart failure who took dapagliflozin were less likely to develop the condition, suggesting that SGLT2 inhibitors could serve as a preventive therapy for genetically high-risk individuals.
Freeman added, “This should be viewed as an exciting hypothesis-generating finding, not yet a practice-changing mandate for all patients with these genetic variants.” He highlighted that SGLT2 inhibitors are already recognized as foundational medications for cardiovascular and kidney protection.
These medications have been shown to reduce heart failure hospitalizations across a diverse range of patients, including those with diabetes, chronic kidney disease, and established heart failure. The current study introduces the potential for genetic information to help identify a subgroup of patients who may benefit significantly from early treatment.
Genetic testing for cardiomyopathy is often employed for diagnosis, family screening, and risk stratification. If future clinical trials confirm these findings, cardiologists may be able to utilize genetic screening to identify high-risk patients, monitor them more closely, and initiate treatments such as SGLT2 inhibitors before the onset of heart failure symptoms.
Freeman noted that heart failure does not always manifest with symptoms immediately; in some cases, the risk may be present years earlier due to inherited genetic factors. Preventive cardiology could play a crucial role in identifying high-risk patients before they experience symptoms such as shortness of breath, fluid retention, or the need for hospitalization.
As always, the decision to medicate should be made in consultation with a healthcare professional, particularly for individuals with a personal or family history of cardiovascular events. This study represents a significant step toward more personalized and effective preventive strategies in cardiology.
According to Fox News, the findings underscore the potential for integrating genetic insights into clinical practice, paving the way for more targeted interventions in the management of heart failure risk.