Wealth of heart failure data supports medical guideline updates and underscores commitment to improving patient outcomes.

AstraZeneca will present 19 abstracts, including 10 oral presentations and five late-breaking presentations, at the European Society of Cardiology (ESC) Congress from 25-28 August 2023, which includes data highlighting the opportunities for improved management in heart failure (HF), and AstraZeneca's leadership across the interconnectedness of chronic diseases.

Among these abstracts will be sub-analyses from the DELIVER trial - a trial that has been pivotal in informing updates to medical guidelines. Notably, new late-breaking data from a pooled analysis of DELIVER and DAPA-HF trials assess the efficacy of Forxiga (dapagliflozin) versus placebo in HF patients whose eGFR levels fell below 25ml/min/1.73m[2]. The findings showed a marked elevation in the risks of CV outcomes in patients with deteriorating kidney function, further reinforcing the connection between heart failure and kidney disease. These patients appeared to benefit with continued treatment of Forxiga.[1]   

New cardiopulmonary data from a sub-analysis of the DELIVER trial demonstrate the effects of Forxiga in patients with HF with preserved ejection fraction (pEF) and chronic obstructive pulmonary disease (COPD) - a common comorbidity that is associated with worse outcomes.[2] In addition, findings from a multi-database cohort study, EXAcerbations of COPD and their OutcomeS in CardioVascular diseases (EXACOS-CV), illustrate increased COPD-driven cardiopulmonary risk including that of decompensated HF, acute coronary syndrome, arrhythmia, and ischemic stroke following a COPD exacerbation.[3  ]

Ruud Dobber, Executive Vice President and President, BioPharmaceuticals Business Unit, AstraZeneca, said: "We are proud of the continued practice-changing evidence from Forxiga trials, informing updates that recognise SGLT2 inhibitors as the first and only HF therapy with a class 1A recommendation. Our data presented at ESC 2023 reinforce how cardiorenal and cardiopulmonary diseases are complex and interconnected; diseases of one organ system negatively impacting another. It's by understanding their interconnections that we'll be able to detect, diagnose and treat people earlier and more effectively for better outcomes." 

• A late-breaking presentation on the rationale and innovative design of the registry-based randomised DAPA-MI trial in patients without type 2 diabetes with acute myocardial infarction.[4  ]

• A late-breaking investigator-supported study, which is the first to show data on the efficacy and safety of the early use of Forxiga in patients admitted with acute decompensated HF. This study includes a broad heart failure population in the acute HF setting, irrespective of their ejection fraction or glycaemic status.[5  ]

• A late-breaking presentation on the use of artificial intelligence to automate the analysis of point of care handheld transthoracic echocardiography in a real world cohort of patients with suspected heart failure.[6  ]

• Real world data from EVOLUTION HF in the UK that shows the treatment inertia that still exists around initiation of guideline-directed medical therapy after a recent hospitalisation for HF (hHF).[7]  

• Investing in new approaches with early science results from a Phase I trial showing the safety, tolerability, and pharmacokinetics of AZD5462. This is a selective relaxin family peptide receptor 1 (RXFP1) agonist which mimics the pregnancy hormone relaxin and its actions on systemic haemodynamics and kidney function, following a single ascending dose and multiple ascending doses administration.[8  ]

Cardiorenal diseases affect hundreds of millions of people around the world.[9] One in three people has multiple chronic conditions such as cardiovascular disease, type-2 diabetes, chronic kidney disease, or heart failure.[10,11] Cardiorenal diseases account for four of the top 10 causes of death, globally.[12] The economic cost of cardiorenal diseases is skyrocketing, (more than $28 trillion from 2023 to 2030) placing a heavy burden on societies, healthcare systems, and governments.[13] These impacts are compounded by common comorbid conditions such as COPD, which is the third leading cause of death globally and significantly increases the risk of cardiovascular events.[12,14  ]

Complete overview of AstraZeneca abstracts at ESC 2023: 

Lead author Abstract title Presentation details
     
EXACOS-CV
Hawkins NM Increased risk Poster
of decompensated Session Title: Cardiovascular disease in
heart failure, primary care
acute coronary Topic: Cardiovascular Disease in Primary
syndrome, Care
arrhythmias and Date: 28 August
ischemic stroke Time: 13:15-14:00
following Location: Station 6
exacerbation of
COPD: results
from a multi
-database cohort
study
 
Forxiga
(dapagliflozin)
Pascual D Impact on atrial Poster
remodelling of Session Title: Non-invasive imaging in
dapagliflozin in heart failure: clinical insights
patients with Topic: Imaging
heart failure Date: 25 August
(MODA TRIAL): Time: 08:15-09:00
baseline echo Location: Station 4
characteristics  
according to
LVEF phenotypes
Solomon SD LATE BREAKER: Presentation
Effects of Session Title: Clinical trial updates on
dapagliflozin in heart failure
patients with Topic: Chronic Heart Failure
heart failure Date: 25 August
and Time: 08:30-10:00
deterioration of Presentation Time: 09:00
kidney function Location: Hub Rembrandt
to eGFR less  
than
25ml/min/1.73m2:
A participant
-level pooled
analysis of the
DAPA-HF and
DELIVER Trials
 
Ekstrom M Worse long-term Poster
prognosis in new Session Title: Heart failure outcomes:
onset HFpEF effects of phenotypes and comorbidities
treated in HF Topic: Pathophysiology and Mechanisms
clinics compared Date: 25 August
to HFrEF and Time: 10:15-11:00
HFmrEF patients, Location: Station 3
reflecting need  
for effective
treatment in
HFpEF. Results
from the
Stockholm
PREFERS Study
Leiner J LATE BREAKER: A Poster
prospective, Session Title: Nuggets from
observational international and large registries
multicentre Topic: Epidemiology, Prognosis, Outcome
registry of Date: 25 August
heart failure Time: 11:15-12:00
patients in Location: Station 3
Germany:  
preliminary
results of the
ongoing H2
-registry
Zhang R Initiation, Poster
titration, and Session Title: Pharmacological therapy
discontinuation in heart failure 2
- utilization of Topic: Pharmacotherapy
heart failure Date: 25 August
medicines in Time: 17:15-18:00
England Location: Station 3
(EVOLUTION HF  
UK)
Pabon MA Influence of Presentation
background Session Title: Insights from recent
therapy on HFpEF trials 1
efficacy of Topic: Pharmacotherapy
dapagliflozin in Date: 26 August
patients with Time: 15:30-16:30
heart failure Presentation Time: 16:10
and improved Location: Science Box 2
ejection  
fraction
(DELIVER)
Chatur S Effect of Presentation
dapagliflozin on Session Title: Insights from recent
outpatient HFpEF trials 1
worsening heart Topic: Pharmacotherapy
failure in Date: 26 August
patients with Time: 15:30-16:30
mildly reduced Presentation Time: 15:30
or preserved Location: Science Box 2
ejection  
fraction: the
DELIVER trial
Peikert A Effect of Presentation
dapagliflozin in Session Title: State-of-the art
patients with treatment of HFmrEF and HFpEF in 2023
heart failure Topic: Treatment
with mildly Date: 27 August
reduced or Time: 08:30-10:00
preserved Presentation Time: 09:24
ejection Location: Bucharest
fraction treated  
with beta
-blockers: the
DELIVER trial
Butt J H Effects of Presentation
dapagliflozin in Session Title: State-of-the-art
heart failure treatment of HFmrEF and HfpEF in 2023
with preserved Topic: Treatment
ejection Date: 27 August
fraction and Time: 08:30-10:00
chronic Presentation Time: 08:48
obstructive Location: Bucharest - Lecture room
pulmonary  
disease: an
analysis of the
DELIVER trial
Wang X Effect of Presentation
dapagliflozin in Session Title: State-of-the-art
patients in Asia treatment of HFmrEF and HFpEF in 2023
with heart Topic: Treatment
failure with Date: 27 August
mildly reduced Time: 08:30-10:00
or preserved Presentation Time: 09:42
ejection Location: Bucharest - Lecture room
fraction:  
insights from
DELIVER
Wang H Importance of Poster
early diagnosis Session Title: Aspects of epidemiology,
and treatment of aetiology, and outcomes in heart failure
heart failure Topic: Epidemiology, Prognosis, Outcome
across the Date: 27 August
spectrum of Time: 11:15-12:00
ejection Location: Station 3
fraction  
Campbell R LATE BREAKER: Presentation
OPERA - AI Session: Late-Breaking Science
reporting of Topic: European Society of Cardiology
handheld Date: 27 August
echocardiography Time: 14:00-15:20
in suspected Presentation Time: 14:26
heart failure Location: Bratislava, Amsterdam
 
Kondo T Efficacy of Poster
dapagliflozin Session Title: More insights into SGLT2i
according to in heart failure
geographic Topic: Pharmacotherapy
regions in Date: 28 August
patients with Time: 16:15-17:00
heart failure: a Location: Station 3
patient-level  
pooled analysis
of DAPA-HF and
DELIVER
Wang H Impact of Poster
worsening renal Session Title: Comorbidities in heart
function in failure: bench to bedside
patients with Topic: Comorbidities
incident heart Date: 28 August
failure across Time: 12:15-13:00
the spectrum of Location: Station 4
ejection  
fraction: a
population-based
longitudinal
study
Cox Z LATE BREAKER: Presentation
DICTATE-AHF: Session: Hot LineTopic: European Society
Early initiation of Cardiology
of dapagliflozin Date: 28 August
in acute heart Time: 14:00
failure Location: Amsterdam
 
James S LATE BREAKER: Presentation
DAPA-MI - Session: Registries on incident and
rationale and prevalent heart failure
innovative Date: 28 August
design for a Time: 15:00-15:15
registry-based Location: Hub Mondrian - The Hub
randomised  
clinical trial
BRILINTA
van den Broek Impact of Presentation
WWA patient-reported Session Title: Cardiovascular risk and
frailty on advancing age
cardiovascular Topic: Cardiovascular Disease in the
outcomes in Elderly
elderly patients Date: 25 August
with non-ST Time: 15:30-16:30
-elevation Presentation Time: 16:10
myocardial Location: Science Box 3
infarction  
AZD5462
Rosenmeier JB Safety, Poster
tolerability, Session Title: Experimental therapies
and for heart failure
pharmacokinetics Topic: Treatment
of AZD5462, a Date: 28 August
small molecule Time: 15:15-16:00
agonist of the Location: Station 3
RXFP1 relaxin  
receptor

ESC 2023 abstracts are available online (https://esc365.escardio.org/ESC-Congress/schedule).

Notes

AstraZeneca in CVRM
Cardiovascular, Renal and Metabolism (CVRM), part of BioPharmaceuticals, forms one of AstraZeneca's main disease areas and is a key growth driver for the Company. By following the science to understand more clearly the underlying links between the heart, kidneys, liver and pancreas, AstraZeneca is investing in a portfolio of medicines for organ protection by slowing or stopping disease progression, and ultimately paving the way towards regenerative therapies. The Company's ambition is to improve and save the lives of millions of people, by better understanding the interconnections between CVRM diseases and targeting the mechanisms that drive them, so we can detect, diagnose and treat people earlier and more effectively.

AstraZeneca
AstraZeneca (LSE/STO/Nasdaq: AZN) is a global, science-led biopharmaceutical company that focuses on the discovery, development, and commercialisation of prescription medicines in Oncology, Rare Disease, and BioPharmaceuticals, including Cardiovascular, Renal & Metabolism, and Respiratory & Immunology. Based in Cambridge, UK, AstraZeneca operates in over 100 countries and its innovative medicines are used by millions of patients worldwide. Please visit astrazeneca.com (https://www.astrazeneca.com/) and follow the Company on social media @AstraZeneca. (https://www.linkedin.com/company/astrazeneca)

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References

1. Solomon D, et al. Effects of Dapagliflozin in Patients with Heart Failure and Deterioration of Kidney Function to eGFR Less Than 25ml/min/1.73m2: A Participant-Level Pooled Analysis of the DAPA-HF and DELIVER Trials. Presented at: ESC 2023, 25-28 August 2023, Amsterdam, Netherlands.
2. Butt J, et al. Effects of dapagliflozin in heart failure with preserved ejection fraction and chronic obstructive pulmonary disease - an analysis of the DELIVER trial. Presented at: ESC 2023, 25-28 August 2023, Amsterdam, Netherlands.
3. Hawkins NM, et al. Increased risk of decompensated heart failure, acute coronary syndrome, arrythmias and ischemic stroke following exacerbation of COPD: results from a multi-database cohort study. Presented at: ESC 2023, 25-28 August 2023, Amsterdam, Netherlands.  
4. James S, et al. Rationale and innovative design of the registry-based randomised DAPA-MI trial: Dapagliflozin in patients without diabetes mellitus with acute myocardial infarction. Presented at: ESC 2023, 25-28 August 2023, Amsterdam, Netherlands.
5. Lindenfeld J, et al. Efficacy and Safety of Dapagliflozin in Acute Heart Failure: DICTATE-AHF. Presented at: ESC 2023, 25-28 August 2023, Amsterdam, Netherlands.
6. Campbell R, et al. OPERA - AI - reporting of handheld echocardiography in suspected heart failure. Presented at: ESC 2023, 25-28 August 2023, Amsterdam, Netherlands.
7. Zhang R, et al. Initiation, titration, and discontinuation - utilization of heart failure medicines in England (EVOLUTION HF UK). Presented at: ESC 2023, 25-28 August 2023, Amsterdam, Netherlands.
8. Rosenmeier J, et al. Safety, tolerability, and pharmacokinetics of AZD5462, a small molecule agonist of the of the RXFP1 relaxin receptor. Presented at: ESC 2023, 25-28 August 2023, Amsterdam, Netherlands.
9. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-22.
10. Mak KH, et al. Prevalence of diabetes and impact on cardiovascular events and mortality in patients with chronic coronary syndromes, across multiple geographical regions and ethnicities. Eur J Prev Cardiol. 2022;28(16):1795-806.
11. Einarson TR, et al. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17(1):83. doi: 10.1186/s12933-018-0728-6. PMID: 29884191; PMCID: PMC5994068.
12. World Heart Organization [Internet]. The top 10 causes of death. [cited 2023 May 25]. Available From: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death    
13. AstraZeneca Data on File: REF-197704.
14. Khan S, et al. Comorbid Chronic Obstructive Pulmonary Disease and Heart Failure: Shared Risk Factors and Opportunities to Improve Outcomes. Ann Am Thorac Soc. 2022 Jun; 19(6): 897-899.