Introduction
Dapagliflozin, a leading SGLT2 inhibitor, has evolved from a glucose-lowering agent to a cornerstone therapy for heart failure (HF). Built on pivotal trials like DAPA-HF and DELIVER, dapagliflozin now targets a broad spectrum of HF patients, including those without diabetes. A recent bibliometric analysis of literature from 2012 to 2024 maps the global research landscape, highlighting hotspots, collaboration patterns, and nascent directions that shape future investigations in dapagliflozin-based HF care.
What the literature shows: growth, geography, and collaboration
A total of 919 publications involving researchers from 76 countries were identified. Since 2016, publication volume has grown steadily, with a marked surge after 2019—coinciding with the DAPA-HF trial results. The United States leads in output (roughly one-third of all work), followed by Sweden and China. The most productive institutions are AstraZeneca, Harvard University, and Brigham and Women’s Hospital, reflecting a mix of industry and academia in advancing dapagliflozin research.
Core authors driving the field include Langkilde, Kosiborod, and Solomon, with notable roles for investigative bridges such as McMurray. Yet, betweenness centrality measurements suggest that collaboration across clusters remains uneven, signaling opportunities for broader, interdisciplinary teamwork to accelerate knowledge transfer and clinical translation.
Hot topics in dapagliflozin and HF: what researchers are chasing
Keyword analyses reveal several dominant themes. First, the patient spectrum is expanding from heart failure with reduced ejection fraction (HFrEF) to heart failure with mid-range or preserved EF (HFpEF), with ongoing exploration of combination therapies. Cardiorenal outcomes and kidney protection (eGFR trajectories, albuminuria) emerge as central concerns, linking HF management with renal health. The emerging practice of pairing SGLT2 inhibitors with mineralocorticoid receptor antagonists (MRAs) reflects a shift toward integrated cardiorenal therapy.
Mechanistic research remains vibrant, examining anti-fibrotic and anti-inflammatory pathways, oxidative stress mitigation, and calcium handling as potential mediators of dapagliflozin’s cardiovascular benefit. Topics such as inflammation, fibrosis, and renoprotection recur in clustering analyses, underscoring a push to translate mechanistic insights into targeted clinical strategies.
HFpEF, burden reduction, and real-world implications
HFpEF has traditionally lacked disease-modifying options; however, recent data suggest dapagliflozin may improve symptoms and functional capacity in this subgroup. The field increasingly frames dapagliflozin within a broader “quadruple therapy” approach alongside renin–angiotensin system inhibitors, β-blockers, and MRAs, reflecting guideline evolution and real-world adoption. Real-world data and cardiovascular outcomes trials continue to shape risk stratification, patient selection, and cost-effectiveness analyses.
Future directions and research needs
Going forward, researchers are likely to prioritize: 1) definitive HFpEF trials clarifying long-term outcomes and patient phenotypes; 2) optimized combination regimens with non-steroidal MRAs and other novel agents; 3) mechanistic studies detailing anti-fibrotic and anti-inflammatory pathways; 4) strategies to maximize renoprotection and preserve eGFR in diverse HF populations; and 5) enhanced international collaboration to overcome geographic gaps in knowledge production. The bibliometric landscape indicates the field is ripe for cross-disciplinary work, including cardiology, nephrology, pharmacology, and health economics.
Takeaways for clinicians and researchers
Clinicians should anticipate increasing use of dapagliflozin across HF phenotypes, guided by evolving guidelines and real-world evidence on cardiorenal benefits. Researchers can leverage the identified hotspots to craft studies that address HFpEF subtypes, explore combination therapies, and elucidate precise mechanisms underpinning the drug’s protective effects. Strengthening international collaboration will be key to translating discoveries into accessible, evidence-based care for HF patients globally.
