Abstract
OBJECTIVES: To investigate the clinical efficacy of dapagliflozin combined with sacubitril/valsartan for heart failure (HF) in elderly patients with Acute Myocardial Failure (AMI) post emergency Percutaneous Coronary Intervention (PCI) and their effects on patients' cardiac function recovery, inflammatory status, and prognosis. METHODS: This retrospective study included 94 elderly AMI patients who developed HF after emergency PCI at Tangshan Gongren Hospital between May 2022 and March 2024. Based on their treatment regimen, the enrolled patients receiving sacubitril/valsartan only were categorized as the control group (n=43), and those who underwent sacubitril/valsartan plus dapagliflozin as the study group (n=51). Patients in both groups were all treated for 12 weeks. Their cardiac function indicators, such as left ventricular ejection fraction (LVEF), HF biomarkers, including B-type natriuretic peptide (BNP), inflammatory factors, such as interleukin-6 (IL-6), tumor necrosis factor-alpha and high-sensitivity C-reactive protein, ventricular remodeling measures, 6-minute walk test (6MWT), quality of life [measured by the scores of Minnesota Living with Heart Failure Questionnaire (MLHFQ)], major adverse cardiac events (MACEs), and adverse drug reactions were compared before and after treatment. RESULTS: After 12-week treatment, the study group showed a marked increase in LVEF (60.3±6.2 vs 54.1±5.7, P < 0.001), a significant reduction in BNP level (23.20±5.12 vs 27.64±4.66 pmol/L, P < 0.001) and in levels of inflammatory factors including (IL-6: 113.25±40.55 vs 142.72±31.20 pg/L, P < 0.001), better performance in 6MWT (447.11±34.08 vs 406.24±31.77 m, P < 0.001), as well as a significant decrease in MLHFQ scores (38.04±4.30 vs 45.51±5.12, P < 0.001) in comparison to the control group. Additionally, patients in the study group demonstrated lower rate of MACE occurrence compared to the control group (9.80% vs 25.58%, P=0.043). However, no significant differences were observed in adverse drug reactions between the two groups (9.80% vs 6.98%, P=0.906). CONCLUSION: Dapagliflozin combined with sacubitril/valsartan can significantly facilitate cardiac function recovery, reduce inflammatory response, enhance exercise tolerance and quality of life, and lower the risk of MACE in elderly AMI patients who developed HF following emergency PCI. The regimen had a favorable safety profile, suggesting good clinical implications.