{ "abstract": "Background Frailty is common in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation and portends worse outcomes. Whether the benefit of posttranscatheter aortic valve implantation dapagliflozin differs by frailty is uncertain. Methods In this post hoc analysis, we investigated the efficacy of dapagliflozin according to frailty status in the DapaTAVI (Dapagliflozin in Patients Undergoing Transcatheter Aortic Valve Implantation) trial. Frailty was assessed through the Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight scale (robust=0, prefrail=1–2, frail=3–5). The primary outcome was the composite of all‐cause death or worsening heart failure at 1 year. Results Among 1222 patients with baseline frailty assessment, 47.2% were frail, 40.3% prefrail, and 12.4% robust. Over 12 months, 215 patients (17.6%) experienced the primary end point. Patients who were prefrail and frail had higher risk than robust patients (adjusted hazard ratios [HRs], 1.88 [95% CI, 1.05–3.38] and 2.29 [1.29–4.07], respectively; P =0.004). Dapagliflozin was associated with a lower risk of the primary end point in patients who were frail (HR, 0.53 [95% CI, 0.36–0.77]) but not in those who were prefrail (HR, 1.01 [95% CI, 0.66–1.55]) or robust patients (HR, 1.26 [95% CI, 0.42–3.75]); P for interaction=0.021. There was no evidence that frailty modified the safety profile of dapagliflozin. Conclusions Frailty was common and independently associated with worse outcomes after transcatheter aortic valve implantation. Dapagliflozin appeared to confer greater relative benefit in patients with frailty.", "abstract_shown": true, "affiliations": [ "Reina Sofia University Hospital", "Maimonides Biomedical Research Institute of Cordoba (IMIBIC)", "Centro Nacional de Investigaciones Cardiovasculares", "Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV)", "University of Córdoba", "University Clinical Hospital of Valladolid", "University Hospital Bellvitge", "University Hospital Montecelo", "University Clinical Hospital of Santiago de Compostela", "Instituto de Investigación Sanitaria Galicia Sur", "Clinical Hospital San Carlos", "University Hospital Puerta del Mar", "University Hospital La Fe", "University Hospital Álvaro Cunqueiro", "University Hospital Virgen de la Victoria", "University Hospital Germans Trias i Pujol", "University Hospital Marqués de Valdecilla", "Instituto de Investigación Valdecilla", "University Hospital of Albacete", "Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)", "University General Hospital of Alicante", "University Hospital Juan Canalejo", "University Hospital Vall D'Hebron", "University Hospital Quiron Salud La Luz", "University Hospital Central de Asturias", "Clinic University Hospital of Valencia", "INCLIVA Biomedical Research Institute", "University Hospital Fundación Jiménez Díaz", "University Clinical Hospital of Salamanca", "Universitat de les Illes Balears", "Cardiovascular Institute, Icahn School of Medicine at Mount Sinai", "University of Santiago de Compostela" ], "article_type": null, "arxiv": null, "author_total": 41, "authors": [ { "affs": [ 0, 1, 2, 3 ], "name": "Rafael Gonzalez‐Manzanares", "orcid": "0000-0001-8446-7369" }, { "affs": [ 0, 1, 3, 4 ], "name": "Soledad Ojeda", "orcid": "0000-0001-7383-6835" }, { "affs": [ 3, 5 ], "name": "Ignacio Amat‐Santos", "orcid": "0000-0002-2311-4129" }, { "affs": [ 6 ], "name": "Albert Ariza‐Solé", "orcid": "0000-0002-0819-6656" }, { "affs": [ 6 ], "name": "Rafael Romaguera", "orcid": "0000-0002-6413-3502" }, { "affs": [ 7, 8, 9 ], "name": "Diego López Otero", "orcid": "0000-0003-2810-3979" }, { "affs": [ 10 ], "name": "Luis Nombela‐Franco", "orcid": "0000-0003-3438-8907" }, { "affs": [ 11 ], "name": "Livia Gheorge", "orcid": "0000-0001-8291-6095" }, { "affs": [ 12 ], "name": "Jorge Sanz‐Sánchez", "orcid": "0000-0003-4991-6549" }, { "affs": [ 5 ], "name": "Carlos Baladrón Zorita" }, { "affs": [ 0, 1 ], "name": "Ignacio Gallo", "orcid": "0000-0002-4486-5685" }, { "affs": [ 9, 13 ], "name": "Rafael Cobas Paz" }, { "affs": [ 14 ], "name": "Antonio Jesús Muñoz García" }, { "affs": [ 15 ], "name": "Victoria Vilalta", "orcid": "0000-0003-1767-5963" }, { "affs": [ 16, 17 ], "name": "Gabriela Veiga Fernández", "orcid": "0000-0002-5512-3820" }, { "affs": [ 18 ], "name": "Juan Gabriel Córdoba Soriano", "orcid": "0000-0003-4645-6268" }, { "affs": [ 19 ], "name": "Pedro Cepas‐Gillén", "orcid": "0000-0001-8814-7039" }, { "affs": [ 20 ], "name": "Miriam Sandín Rollán", "orcid": "0000-0002-6775-6502" }, { "affs": [ 21 ], "name": "Xacobe Flores Ríos" }, { "affs": [ 22 ], "name": "Ricardo Palma‐Carbajal", "orcid": "0000-0002-9577-349X" }, { "affs": [ 23 ], "name": "Roberto Martín Reyes" }, { "affs": [ 24 ], "name": "Pablo Avanzas", "orcid": "0000-0002-4958-6108" }, { "affs": [ 3, 25, 26 ], "name": "Sergio García Blas", "orcid": "0000-0002-1998-3735" }, { "affs": [ 27 ], "name": "Juan A. Franco‐Peláez" }, { "affs": [ 28 ], "name": "Javier Martín Moreiras", "orcid": "0000-0002-9204-243X" }, { "affs": [ 8 ], "name": "José Ramón Gonzalez Juanatey" }, { "affs": [ 10 ], "name": "Nieves Gonzalo", "orcid": "0000-0003-3827-945X" }, { "affs": [ 11 ], "name": "German Calle", "orcid": "0000-0003-0025-1929" }, { "affs": [ 12 ], "name": "José Luis Díez", "orcid": "0000-0001-9921-8023" }, { "affs": [ 13 ], "name": "Sandra Santos‐Martínez", "orcid": "0000-0003-4244-6919" }, { "affs": [ 9, 13 ], "name": "Rocío González Ferreiro", "orcid": "0000-0001-8312-4874" }, { "affs": [ 14 ], "name": "Erika Muñoz García" }, { "affs": [ 15 ], "name": "Eduard Fernandez‐Nofrerias", "orcid": "0000-0003-2219-921X" }, { "affs": [ 7, 8, 9 ], "name": "Xoan Sanmartín" }, { "affs": [ 10 ], "name": "Gabriela Tirado", "orcid": "0000-0002-7093-3936" }, { "affs": [ 11 ], "name": "Alejandro Gutierrez Barri" }, { "affs": [ 9, 13 ], "name": "Inmaculada González Bermúdez", "orcid": "0000-0003-3757-9872" }, { "affs": [ 2, 29 ], "name": "Xavier Rosselló", "orcid": "0000-0001-6783-8463" }, { "affs": [ 2, 30 ], "name": "Valentín Fuster" }, { "affs": [ 2, 3, 27 ], "name": "Borja Ibáñez", "orcid": "0000-0002-5036-254X" }, { "affs": [ 2, 9, 13, 31 ], "name": "Sergio Raposeiras Roubín", "orcid": "0000-0002-6462-4715" } ], "bibtex": "https://research.draconitic.com/paper/3mrxvx8xr2td5.bib", "cited_by": 0, "doi": "10.1161/jaha.126.051379", "fulltext_url": null, "id": "3mrxvx8xr2td5", "issns": [ "2047-9980" ], "landing_url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.051379", "language": null, "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2705|Cardiac Valve Diseases and Treatments" ] ], "openalex": "W7222642413", "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-10-20", "publisher": "Ovid Technologies (Wolters Kluwer Health)", "ris": "https://research.draconitic.com/paper/3mrxvx8xr2td5.ris", "sources": [ { "first_seen": "2026-10-30T12:20:28Z", "native_id": "10.1161/jaha.126.051379", "source": "crossref", "url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.051379" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2705|Cardiac Valve Diseases and Treatments", "subfield": "cardiovascular" } ], "title": "Dapagliflozin After Transcatheter Aortic Valve Implantation According to Frailty in DapaTAVI Trial", "title_text": "Dapagliflozin After Transcatheter Aortic Valve Implantation According to Frailty in DapaTAVI Trial", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:28Z", "url": "https://research.draconitic.com/paper/3mrxvx8xr2td5", "venue": "Journal of the American Heart Association", "versions": [] }