Prognostic Role And Cardiac Function Of Dapagliflozin Combined With Sacubitril Valsartan In The Treatment Of Chronic Heart Failure

Objective: To observe the cardiac function and prognosis of Dapagliflozin combined with Sacubitril valsartan in the treatment of chronic heart failure(CHF)regardless of presence or absence of diabetes mellitus.Method: This research was a single-center prospective observational study,A total of 117 cases of patients with CHF regardless of whether diabetes mellitus who were diagnosed and treated in the hospital from February 2020 to February 2021 were selected and randomly divided into two groups.58 cases in Sacubitril valsartan group and 59 cases in combined treatment group.In addition to,patients in two group were given personalized basic heart failure treatment drugs.The differences in left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEED),N-terminal B-type natriuretic peptide(NT-Pro BNP),systolic blood pressure(SBP),diastolic blood pressure(DBP),HBA1 c,body mass index(BMI),6minte walking test(6WMT),C-reaction protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-(TNF-)were analyzed after 12 months of treatment.The two group were compared to see if there were any difference in complications during the medication.Survival curve was draw by Kaplan-Meier.Results: there was no significant difference in baseline data between the two groups before treatment(p>0.05),After treatment,there were statistically significant differences in LVEF,LVEED,NT-Pro BNP,SBP,BMI,6WMT,CRP,IL-6,TNF-among two groups(p<0.05).there were statistically significant differences in LVEF,LVEED,NT-Pro BNP,SBP,6WMT,CRP,IL-6,TNF-in Sacubitril Valsartan group(p<0.05).there were statistically significant differences in LVEF,LVEED,NTPro BNP,BMI,SBP,6WMT,CRP,IL-6,TNF-in combined treatment group(p<0.05).Using heart failure readmission as endpoint events,Kaplan-Meier survival curves were plotted,the combined treatment group had the lowest cumulative incidence of heart failure readmission,the overall survival rate was more than those Sacubitril valsartan group.The incidence of adverse events was no statistically significant between the two groups.Conclusion: the result of this study indicate that Sacubitril Valsartan can improve cardiac function,delay left ventricular remodeling,inhibiting inflammatory response,enhance activity endurance.For patient with chronic heart failure.The combination of Sacubitril Valsartan and Dapagliflozin was superior to Sacubitril Valsartan alone in improving clinical efficacy and regulated body weight and blood pressure as a risk factor for chronic heart failure.There was no difference in the incidence of adverse events in the two groups.Although Major adverse cardiovascular event was no statistically significant between two groups,Kaplan-Meier survival curves trends indicated that a low cumulative readmission risk in the combined treatment group.The combination of Sacubitril Valsartan and Dapagliflozin is recommended for heart failure with reduced ejection in the absence of contraindication.