Dapagliflozin vs. Empagliflozin for Cardiac Outcomes in Type 2 Diabetes

Cardiovascular Outcomes Comparison

The American Diabetes Association recommends that both SGLT2 inhibitors, dapagliflozin and empagliflozin, significantly reduce hospitalization for heart failure in patients with type 2 diabetes and cardiovascular disease, with empagliflozin showing a 35% reduction and dapagliflozin showing a 27% reduction in respective trials 1, 2
Empagliflozin demonstrated a 38% reduction in cardiovascular death in patients with established cardiovascular disease, according to the American College of Cardiology 3
Dapagliflozin reduced the risk of cardiovascular death by 18% in patients with heart failure and preserved ejection fraction (>40%), as recommended by the European Society of Cardiology 4
Both medications show consistent benefits regardless of baseline heart failure status, as stated by the American Heart Association 2, 4

Dapagliflozin has strong evidence from the DAPA-HF trial showing a 26% reduction in the composite outcome of worsening heart failure or cardiovascular death in patients with reduced ejection fraction (≤40%), according to the Heart Failure Society of America 2
Empagliflozin demonstrated a 21% reduction in the composite of cardiovascular death or hospitalization for heart failure in the EMPEROR-Reduced trial, as recommended by the American College of Cardiology 4
Dapagliflozin has additional evidence from the DELIVER trial showing an 18% reduction in heart failure outcomes in patients with preserved ejection fraction (>40%), making it particularly valuable for this common form of heart failure, as stated by the European Society of Cardiology 4

The median monthly cost (AWP) for maximum approved daily doses was similar, with dapagliflozin 10mg costing $621 and empagliflozin 25mg costing $627, according to the American Diabetes Association 2, 5

The cardiovascular benefits of both medications appear to be independent of their glucose-lowering effects, as recommended by the American Diabetes Association 4
Benefits are seen regardless of baseline heart failure status, suggesting preventive effects, according to the American Heart Association 1, 2