Nassif ME, Windsor SL, Tang F, et al. - Researchers investigated the effects of dapagliflozin in heart failure (HF) patients with left ventricular ejection fraction ≤ 40%, NYHA class II-III, estimated glomerular filtration rate ≥ 30 mL/min/1.73m², and raised natriuretic peptides in an investigator-initiated, multi-center, randomized controlled trial named DEFINE-HF (Dapagliflozin Effects on Biomarkers, Symptoms and Functional Status in Patients with HF with Reduced Ejection Fraction). Using randomization, a total of 263 patients were assigned to dapagliflozin 10 mg daily or placebo for 12 weeks. Mean NT-proBNP (N-terminal pro b-type natriuretic peptide) as well as proportion of patients with ≥ 5-point rise in HF disease-specific health status on the Kansas City Cardiomyopathy Questionnaire overall summary score, or a ≥ 20% reduction in NT-proBNP, were assessed as dual primary outcomes. Findings revealed no influence of dapagliflozin treatment for 12 weeks on mean NT-proBNP, however, this therapy led to a rise in the proportion of patients with clinically meaningful improvements in HF-associated health status or natriuretic peptides among patients with heart failure and reduced ejection fraction. The advantages of dapagliflozin on clinically meaningful HF measures seemed to extend to patients without type 2 diabetes mellitus.