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Abstract

 
Background: Heart failure (HF) remains a major global health burden with limited treatment options, especially in non-diabetic populations. Sodium–glucose co-transporter 2 inhibitors (SGLT2is), such as dapagliflozin, have shown promising cardiovascular benefits beyond glycemic control. While most studies have focused on diabetic patients, emerging evidence suggests potential efficacy in non-diabetic HF cohorts. Understanding dapagliflozin's role in improving clinical outcomes in this specific population is essential for refining heart failure treatment strategies.
Objective: To evaluate the clinical efficacy and tolerability of dapagliflozin in non-diabetic patients with heart failure.
Methods: This descriptive study was conducted over five months at the Department of Cardiology, PIMS, Islamabad. A total of 150 non-diabetic HF patients, aged 30–70 years, were enrolled using non-probability consecutive sampling. Participants received oral dapagliflozin 10 mg daily for 12 weeks. Baseline and post-treatment assessments included Pro-BNP levels and NYHA functional class. Tolerability was monitored through adverse event reporting. Statistical analysis was performed using IBM SPSS version 23. Quantitative variables were expressed as means ± SD, and categorical variables as frequencies and percentages. A p-value of ≤ 0.05 was considered statistically significant.
Results: After 12 weeks, 66 participants (44.0%) achieved Pro-BNP normalization (<450 pg/mL), and 72 (48.0%) improved to NYHA Class I (p < 0.001 for both). A combined efficacy outcome was observed in 58 patients (38.7%). The drug was well-tolerated by 124 individuals (82.7%) without major adverse events. Subgroup analysis revealed higher efficacy in HFrEF patients (50.0%) compared to HFpEF (36.5%) (p = 0.03).
Conclusion: Dapagliflozin significantly improves functional and biomarker outcomes in non-diabetic HF patients, especially those with reduced ejection fraction. Its favorable safety profile supports broader clinical application, though long-term evaluation is warranted.