Efficacy And Prognosis Analysis Of Sodium-glucose Cotransporter-2 Inhibitor In The Treatment Of Heart Failure With Reduced Ejection Fraction

Objective:To investigate the clinical efficacy and prognosis of the sodium-glucose cotransporter-2 inhibitor dapagliflozin on the basis of the standard treatment regimen for reduced ejection fraction in patients with heart failure.Method:This research as a single-center prospective observational study,who were in October 2018 to October 2019,our hospital outpatient and hospitalization diagnosis and treatment of 147 cases with or without type 2 diabetes patients with chronic HFr EF as the research object,using the random number table method is divided into the control group(74 cases)and observation group(73 cases)and control group receiving HFr EF standard drug therapy,observation group in the HFr EF standard drug therapy on the basis of combined use of SGLT-2 dapagliflozin 10 mg/d,followed up for 12 months,to cardiovascular death or hospitalization for heart failure and end as the main adverse events,Furthermore,Kaplan-Meier survival curve was used to compare the incidence of primary end points and rehospitalizations due to heart failure within 12 months of treatment between the two groups and the subgroups according to the pre-set subgroup with or without type 2 diabetes.The n-terminal pro-brain natriuretic peptide(NT-pro BNP),the left ventricular ejection fraction(LVEF),and the left ventricular end diastolic diameter(LVEDD)were also compared between the two groups after 12 months of treatment.6-minute walking(6WMT)distance,changes in the Minnesota Heart Failure Quality of Life Scale score(MHFQL),and incidence of adverse events.Results:Compared with the control group,SGLT-2 inhibitor was associated with a40% reduction in the relative risk of major adverse end events(HR=0.60,95%CI(0.37-0.99),P = 0.046),with a significantly lower incidence of rehospitalization for heart failure(HR=0.56,95%CI(0.31-0.99),P = 0.047).In group with type 2 diabetes and heart failure,the incidence of major adverse end point events(HR = 0.62,95% CI(0.32-1.23),P = 0.173),significantly lower than the control group,the group is not associated with type 2 diabetes and heart failure,the incidence of the primary end point events(HR = 0.58,95% CI(0.28-1.23),P = 0.155)and significantly lower than the control group,but no statistical significance(P > 0.05).Before treatment,NT-pro BNP,LVEF,LVEDD,6-minute walking distance and Minnesota heart failure quality of life scale scores were compared between the two groups,and the differences were not statistically significant(P > 0.05).After treatment,NT-pro BNP,LVEF and LVEDD in the two groups were improved(P < 0.05),and there was no significant difference in the improvement effect between the observation group and the control group(P > 0.05).The 6-minute walking distance and the Minnesota heart failure scale score(MHFQL)were significantly improved in both groups(P < 0.05),and the improvement in the observation group was better than that in the control group(P <0.05).There was no significant difference in the incidence of adverse events between the two groups(P > 0.05).Conclusion:The application of the SGLT-2 inhibitor dapagliflozin on the basis of the standard treatment plan of HFr EF can further reduce the risk of cardiovascular death or rehospitalization due to heart failure,and can improve the quality of life of patients,and has good safety.