Objective To explore the effects of different sodium-glucose co-transporter 2(SGLT2)inhibitors com-bined with diuretics on renal function,cardiac function,and clinical safety in patients with chronic heart failure(CHF).Meth-ods A randomized,open-label,single-center prospective clinical cohort study was conducted.A total of 96 CHF patients admitted to the Second Department of Cardiology,Second People's Hospital of Kashgar,from June 2022 to December 2023 were selected as the research subjects and divided into three groups using a random number table:the dapagliflozin group(n=32),the canagliflozin group(n=32),and the control group(n=32).All patients received conventional basic treatment for heart failure.Additionally,the dapagliflozin group was treated with dapagliflozin,the canagliflozin group with canaglifloz-in,and the control group without any extra medication.All patients were followed up after 3 months of continuous treat-ment.Observations included cardiac function-related indicators[left ventricular ejection fraction(LVEF),left ventricular mass index(LVMI),left ventricular remodeling index(LVRI)],heart failure-related serological markers[plasma brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide(NT-proBNP)],ventricular remodeling-related indicators[cystatin C(CysC),fibroblast growth factor 23(FGF23),matrix metalloproteinase 9(MMP-9)],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],renal function indicators[serum creatinine(SCr),blood urea ni-trogen(BUN),glomerular filtration rate(GFR)],and drug-related adverse reactions.Results After treatment,the LVEF,LVRI,and GFR of the three groups were higher than before treatment,while the levels of LVMI,BNP,NT-proBNP,CysC,FGF23,MMP-9,SCr,and BUN was lower.The changes in cardiac function indicators,heart failure-related serological mark-ers,ventricular remodeling-related indicators,and renal function indicators in the dapagliflozin and canagliflozin groups were greater than those in the control group(F/P=13.740/＜0.001,6.415/0.002,8.520/＜0.001,12.184/＜0.001,15.945/＜0.001,14.927/＜0.001,12.330/＜0.001,8.755/＜0.001,20.388/＜0.001,12.055/＜0.001,10.196/＜0.001),but there was no statistically significant difference between the dapagliflozin and canagliflozin groups(P＞0.05).After treatment,the serum levels of CRP,IL-6,and TNF-α in the three groups were lower than before treatment,but there was no statistically significant difference between the groups(F/P=0.101/0.904,1.449/0.442,0.021/0.979).There were no statistically significant differences in the inci-dence of adverse events among the three groups(x2/P=0.571/0.751).Conclusion Both dapagliflozin and canagliflozin combined with SGLT2 inhibitors on top of basic treatment can effectively improve cardiac and renal function in CHF pa-tients,significantly reduce inflammation levels,heart failure-related serological markers,and the degree of ventricular remode-ling.The combined use of different types of SGLT2 inhibitors shows high clinical safety and may have significant clinical application value for improving long-term prognosis in CHF patients.
维普
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