Efficacy and safety of sacubitril/valsartan combined with dapagliflozin in patients with hypotensive chronic heart failure
Objective:To investigate the effect of sacubitril/valsartan combined with dapagliflozin in patients with hypotensive chronic heart failure.How:A total of 153 patients with hypotension and chronic heart failure treated in our hospital from June 2021 to March 2023 were divided into a control group(n=77)and an observation group(n=76)by random number table method.They were treated with sacubitril/valsartan 50 mg orally or sacubitril/valsartan combined with dapagliflozin 10 mg orally,respectively.After 6 months of treatment,blood pressure was measured by sphygmomanometer,glycosylated hemoglobin was detected by ion exchange chromatography,high-sensitivity troponin T was detected by electrochemiluminescence technique,and N-terminal pro-brain natriuretic peptide was detected by enzyme-linked immunosorbent assay.The level of cardiac function,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular posterior wall thickness was measured by color Doppler ultrasound system.The quality of life was evaluated by the Minnesota Heart Failure Quality of Life Scale,and the occurrence of clinical events was counted.Results:There were 13 cases of abscission,6 cases in the observation group and 7 cases in the control group.After 6 months of treatment,the blood pressure of both groups decreased,but the observation group was higher than the control group(P<0.05).After 6 months of treatment,HBA1C,T-terminal and N-terminal brain natriuretic peptide precursors of high-sensitivity troponin in both groups were lower than before treatment,and the observation group was lower than the control group(P<0.05).After 6 months of treatment,the left ventricular ejection fraction in both groups was higher than before treatment,the observation group was higher than the control group(P<0.05),and left ventricular end-diastolic diameter and left ventricular posterior wall thickness were lower than before treatment,the observation group was lower than the control group(P<0.05).After 6 months of treatment,the Minnesota heart failure quality of life score in both groups was lower than before treatment,and the observation group was lower than the control group(P<0.05).After 6 months of treatment,the total incidence of clinical events in the observation group was lower than in the control group(χ2=3.944,P=0.047).Conclusion:Compared with Sacubitril/valsartan alone,Sacubitril/valsartan combined with dapagliflozin can improve cardiac function,improve the quality of life,and reduce the risk of hypotension and renal insufficiency in patients with chronic heart failure.
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