Effect of dapagliflozin combined with sacubitril/valsartan on heart failure with preserved ejection fraction
Objective To investigate the clinical benefit and safety of dapagliflozin combined with sacubitril/valsartan on heart failure with preserved ejection fraction(HFpEF).Methods A total of 256 HFpEF patients from January 2022 to March 2023 were enrolled and randomly divided into 4 groups.All patients were treated with guideline-recommended basic drugs for heart failure,including β-blockers,diuretics,and aldosterone receptor antagonists.Among them,the combined treatment group was treated with dapagliflozin combined with sacubitril/valsartan;the dapagliflozin group was treated with dapagliflozin alone;the sacubitril/valsartan group was treated with sacubitril/valsartan alone;and the basic treatment group was treated with basic drug and angiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker(ACEI/ARB).After 1 year of follow-up,the incidence of major adverse cardiovascular events(MACE),the Kansas City Cardiomyopathy Questionnaire(KCCQ)score,the left ventricular end-systolic diameter(LVESD),the left ventricular end-diastolic diameter(LVEDD),the left ventricular end-diastolic volume(LVEDV),the left ventricular ejection fraction(LVEF),the left ventricular mass index(LVMI),and the N-terminal pro-brain natriuretic peptide(NT-proBNP)were compared among the four groups to assessment the efficacy of combined treatment versus monotherapy and basic treatment.Adverse drug reactions of the four groups were observed.Results Compared with the basic treatment group,the combined treatment group,dapagliflozin group,and sacubitril/valsartan group had a lower incidence of MACE events,and the combined treatment group had the lowest incidence of MACEs(P＜0.05).The KCCQ scores of the four groups were all significantly improved than before treatment,which of the combination group were significantly improved more than other three groups(P＜0.05).The echocardiographic data of the four groups were compared.LVESD in the combined treatment group decreased more significantly than that in the dapagliflozin group and the basic treatment group;LVEDD in the combined treatment group decreased more significantly than that in the sacubitril/valsartan group and the basic treatment group;LVEF in the combined treatment group increased more significantly than that in the other three groups;and LVMI in the combined treatment group decreased more significantly than that in the basic treatment group(P＜0.05).After treatment,the level of NT-proBNP in the combined treatment group was significantly lower than that in the other three groups(P＜0.05).There was no significant difference in the total incidence of adverse events among the four groups(P＞0.05).Conclusion Dapagliflozin combined with sacubitril/valsartan on the treatment of HFpEF can bring more clinical benefits without increasing safety risks.
heart failure with preserved ejection fractiondapagliflozinsacubitril/valsartanheart failureKansas City Cardiomyopathy Questionnaire(KCCQ)
万方数据
维普
