Adults with type 2 diabetes who carry a rare gene variant tied to cardiomyopathy saw an 82% lower risk of being hospitalized for heart failure when they took the SGLT2 inhibitor dapagliflozin, compared with placebo.
In participants without the variant, the same drug reduced hospitalizations by 32%.
The finding comes from a June 2026 analysis in Nature Medicine, drawn from the DECLARE-TIMI 58 trial.
Researchers ran whole-exome sequencing on 12,685 participants and identified 121 who carried a pathogenic cardiomyopathy variant.
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Over a median 4.2 years of follow-up, 16% of variant carriers assigned placebo were hospitalized for heart failure. Among carriers assigned dapagliflozin, that rate fell to 3%.
Why the gene status matters
Cardiomyopathy is a disease of the heart muscle that can weaken pumping over time and lead to heart failure.
Some cases are linked to inherited variants in genes that shape how heart muscle cells contract, and carriers often go years without symptoms before problems surface.
Historically, learning you had one of these variants offered risk information but few preventive options.
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"Historically, identifying a genetic variant for cardiomyopathy mostly meant telling a patient they were at high risk and not having a specific preventative therapy to offer," said Shinwan Kany, MD, a visiting scientist at the Mass General Brigham Cardiovascular Research Center, in a press release from Mass General Brigham.
The DECLARE-TIMI 58 trial enrolled adults with type 2 diabetes and elevated cardiovascular risk.
All participants in the new analysis had diabetes, and the authors caution that further research is needed before extending the finding to carriers who do not have diabetes.
What dapagliflozin is
Dapagliflozin is the active ingredient in AstraZeneca's Farxiga, an SGLT2 inhibitor that lowers blood sugar by helping the kidneys clear glucose in urine.
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The class has been shown in earlier trials to reduce heart failure hospitalizations in patients with and without diabetes.
Cost is another moving piece. The FDA cleared the first true generic versions of dapagliflozin on April 7, 2026, for reducing heart failure hospitalization risk in adults with type 2 diabetes and either established cardiovascular disease or multiple cardiovascular risk factors.
What it means in practice
The 82% figure comes from a small subset, 121 carriers out of nearly 13,000 participants, and it is a post hoc analysis rather than a purpose-built trial.
That means the researchers looked back at data collected for a different question, so the numbers point toward benefit rather than prove it.
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Prospective studies in carriers without diabetes are needed to confirm the effect.
For readers with a strong family history of heart failure or unexplained cardiomyopathy, a conversation with a cardiologist about referral for genetic testing is the concrete next step.
If a pathogenic variant is found and diabetes is also present, this analysis gives one more reason to discuss whether an SGLT2 inhibitor belongs in the treatment plan.
Generic dapagliflozin is now on US pharmacy shelves alongside the branded Farxiga.
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This article is made and published by Mie Hermansen, who may have used AI in the preparation.