Effects of empagliflozin combined with sacubitril/valsartan on cardiac function and serum sST2 and MMP-9 levels in patients with heart failure with reduced ejection fraction
Objective To investigate the effects of empagliflozin combined with sacubitril/valsartan on cardiac function,serum soluble suppression of tumorigenicity 2 protein(sST2)and matrix metalloproteinase-9(MMP-9)in patients with heart failure with reduced ejection fraction(HFrEF).Methods A total of 185 HFrEF patients from Shenmu Hospital from March 2020 to May 2022 were selected and were divided into an observation group(93 cases)and a control group(92 cases)by the random number table method.In the control group,62 males and 30 females,aged(54.61±8.83)years,were treated with sacubitril/valsartan on the basis of conventional treatment,50 mg each time,twice a day,and the dose was gradually increased according to the patients'conditions,with the maximum dose ≤400 mg/d.In the observation group,65 males and 28 females,aged(55.32±8.21)years,were treated with sacubitril/valsartan combined with empagliflozin on the basis of conventional treatment,and the treatment with sacubitril/valsartan was the same as the control group,with empagliflozin 10 mg each time,once a day.Both groups were treated for 6 months.The cardiac function,motor ability,serological indexes,clinical efficacy,adverse drug reactions,and prognosis of the two groups were compared.Statistical methods used were t test and x2 test.Results After treatment,the left ventricular end-systolic diameter,left ventricular ejection fraction,6 min walking distance,and levels of sST2 and MMP-9 in the observation group were(40.03±3.36)mm,(56.97±6.78)％,(367.29±68.51)m,(3.47±1.20)μg/L,and(143.62±13.28)μg/L,and those in the control group were(44.10±4.22)mm,(50.34±5.68)％,(320.06±59.38)m,(8.61±2.34)μg/L,and(160.34±16.51)μg/L,with statistically significant difference(all P＜0.05).After treatment,the total effective rates of the observation group and the control group were 78.49％(73/93)and 58.70％(54/92),with a statistically significant difference(x2=8.424,P=0.004).The total incidence of cardiovascular adverse events and readmission rate were 20.43％(19/93)and 11.83％(11/93)in the observation group,and 47.83％(44/92)and 28.26％(26/92)in the control group,with statistically significant differences(both P＜0.05).The incidence of adverse drug reactions was 16.13％(15/93)in the observation group and 10.87％(10/92)in the control group,without statistically significant difference(x2=1.095,P=0.295).Conclusion Empagliflozin combined with sacubitril/valsartan can improve the prognosis,exercise ability and cardiac function of HFrEF patients with significant efficacy,and inhibit myocardial fibrosis,which is safe and reliable.
Heart failureEjection fractionEmpagliflozinSacubitril/valsartanHeart functionSoluble suppression of tumorigenicity 2 proteinMatrix metalloproteinase-9
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维普
