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Sacubitril/valsartan plus dapagliflozin improves cardiac function and reduces MACE and rehospitalization in hFrEF: a
Nimin Lu1, Jinzhao Li2, Tianzhu Li3
1Cardiac Rehabilitation Center, The First Affiliated Hospital of Jinzhou Medical University Jinzhou 121001, Liaoning, China.
Insights
Adding dapagliflozin to sacubitril/valsartan significantly improved cardiac function and exercise tolerance in heart failure with reduced ejection fraction (HFrEF) patients. This combination therapy reduced major adverse cardiovascular events (MACE) and hospital readmissions without increasing adverse reactions.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- Heart failure with reduced ejection fraction (HFrEF) remains a significant cause of morbidity and mortality.
- Current therapies aim to improve cardiac function and reduce adverse events.
- Novel therapeutic combinations are being investigated to enhance treatment efficacy.
Purpose of the Study:
- To assess the efficacy and safety of combining sacubitril/valsartan with dapagliflozin in HFrEF patients.
- To compare the outcomes of this combination therapy against sacubitril/valsartan monotherapy.
Main Methods:
- A retrospective study involving 400 HFrEF patients, divided into a control group (sacubitril/valsartan) and an observation group (sacubitril/valsartan + dapagliflozin).
- Patients were treated for 6 months, with assessments including cardiac function (LVEF, LVEDD, LVESD), NT-proBNP levels, 6-minute walk test (6MWT), major adverse cardiovascular events (MACE), readmission rates, and adverse reactions.
Main Results:
- The combination group showed a significantly greater improvement in left ventricular ejection fraction (LVEF) compared to the control group.
- Reductions in left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and NT-proBNP were more pronounced in the combination group.
- The combination therapy resulted in significantly lower readmission rates and MACE, with no significant increase in adverse reactions.
Conclusions:
- Sacubitril/valsartan combined with dapagliflozin offers superior clinical benefits in HFrEF patients compared to sacubitril/valsartan alone.
- This combination improves cardiac function, enhances exercise capacity, and reduces cardiovascular events and hospitalizations.
- The addition of dapagliflozin to sacubitril/valsartan is a safe and effective strategy for managing HFrEF.
Objective:
To evaluate the efficacy and safety of sacubitril/valsartan combined with dapagliflozin in heart failure with reduced ejection fraction (HFrEF).
Methods:
A retrospective study included 400 HFrEF patients (control group: sacubitril valsartan, n=200; observation group: add dapagliflozin, n=200) treated for 6 months. Cardiac function, NT-proBNP, 6MWT, MACE, readmission rate, and adverse reactions were compared.
Results:
After treatment, LVEF increased in both groups (control: 32.5 ± 5.6% to 38.6 ± 6.2%; observation: 32.8 ± 5.4% to 42.3 ± 6.5%, P<0.05), with greater improvement observed in observation group. LVEDD, LVESD, and NT-proBNP decreased, while 6MWT increased in both groups (all P<0.05), with superior changes in observation group. Readmission rate (8.5% vs. 16.0%, P=0.022) and MACE (6.0% vs. 9.5%, P=0.040) were significantly lower in observation group. No significant differences in adverse reactions between groups (all P>0.05).
Conclusion:
Sacubitril valsartan combined with dapagliflozin improves cardiac function, reduces NT-proBNP, enhances exercise tolerance, and lowers readmission and MACE rates without increasing adverse reactions, offering better clinical net benefit than sacubitril valsartan alone.
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