The SOGALDI-PEF randomized clinical trial has published its primary results in the Journal of the American College of Cardiology (JACC) in July 2025, marking an important contribution to the management of heart failure with preserved or mildly reduced ejection fraction.
SOGALDI-PEF was designed as a prospective, randomized, open-label, blinded-endpoint cross-over trial involving 108 outpatients with symptomatic heart failure. The study compared the effects of dapagliflozin alone versus dapagliflozin combined with spironolactone, a mineralocorticoid receptor antagonist, on cardiac biomarkers and key clinical parameters.
The results demonstrate that combination therapy led to a significantly greater reduction in NT-proBNP levels, a widely used biomarker of cardiac stress, compared with dapagliflozin monotherapy, indicating enhanced modulation of cardiac dysfunction. Secondary outcomes highlighted associated effects on kidney function and serum potassium, reinforcing the need for careful clinical monitoring when using combination regimens.
The publication of these findings in a high-impact cardiovascular journal underscores the relevance of the SOGALDI-PEF trial in shaping future research and informing clinical decision-making for patients with heart failure and preserved ejection fraction.
