DECLARE–TIMI 58 HF Risk Reduction Score: Explanation and Clinical Context The DECLARE–TIMI 58 trial evaluated over 17,000 patients with type 2 diabetes, with or without established atherosclerotic cardiovascular disease, assessing dapagliflozin versus placebo for major adverse cardiovascular and heart failure outcomes. The study demonstrated a significant reduction in hospitalization for heart failure, irrespective of baseline atherosclerotic disease, with greater benefit observed in those with pre-existing heart failure, chronic kidney disease, or elevated albuminuria.
This calculator provides a simplified representation of the relative risk for heart failure hospitalization and the expected benefit magnitude from dapagliflozin based on major DECLARE–TIMI 58 predictors. Parameters such as age, renal function, albuminuria, and prior heart failure contribute most strongly to the estimated benefit magnitude.
Clinically, identifying patients at higher baseline HF risk is crucial, as the absolute benefit from SGLT2 inhibitors increases with baseline risk. This model assists in risk stratification and supports evidence-based decision-making for HF prevention in type 2 diabetes management.
Reference:
Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380:347–357.
Cannon CP, McGuire DK, Pratley R, et al. Design and baseline characteristics of the DECLARE–TIMI 58 trial. Diabetes Care. 2018;41:286–294.
Cannon CP, et al. Dapagliflozin and prevention of heart failure in type 2 diabetes: DECLARE–TIMI 58 analysis. Circulation. 2020;141:355–367.