Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 5008-5015
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5008
Dapagliflozin and sacubitril on myocardial microperfusion in patients with post-acute myocardial infarction heart failure and type 2 diabetes
Yuan Lv, Wei-Jun Luo
Yuan Lv, Wei-Jun Luo, Department of Cardiology, Lishui People's Hospital, Lishui 323000, Zhejiang Province, China
Author contributions: Lv Y conceived the entire study and wrote the article; Luo WJ collected the data and completed the analyses; All authors reviewed the manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Lishui People's Hospital.
Informed consent statement: The data used in this study did not involve patients' private information, and all patient data were obtained, recorded, and managed for the sole purpose of this study and without causing any harm to the patients. Therefore, the Ethics Committee of Lishui People's Hospital has waived the requirement of informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Jun Luo, BMed, Associate Chief Physician, Department of Cardiology, Lishui People's Hospital, No. 15 Mass Street, Liandu District, Lishui 323000, Zhejiang Province, China. lwj18957091539@163.com
Received: May 7, 2024
Revised: June 9, 2024
Accepted: June 18, 2024
Published online: August 6, 2024
Processing time: 55 Days and 20.4 Hours
Abstract
BACKGROUND

Coronary heart disease and type 2 diabetes mellitus (T2DM) frequently coexist, creating a complex and challenging clinical scenario, particularly when complicated with acute myocardial infarction (AMI).

AIM

To examine the effects of dapagliflozin combined with sakubactrovalsartan sodium tablets on myocardial microperfusion.

METHODS

In total, 98 patients were categorized into control (n = 47) and observation (n = 51) groups. The control group received noxital, while the observation group was treated with dapagliflozin combined with noxital for 6 months. Changes in myocardial microperfusion, blood glucose level, cardiac function, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level, growth differentiation factor-15 (GDF-15) level, and other related factors were compared between the two groups. Additionally, the incidence of major adverse cardiovascular events (MACE) and adverse reactions were calculated.

RESULTS

After treatment, in the observation and control groups, the corrected thrombolysis in myocardial infarction frame counts were 37.12 ± 5.02 and 48.23 ± 4.66, respectively. The NT-proBNP levels were 1502.65 ± 255.87 and 2015.23 ± 286.31 pg/mL, the N-terminal pro-atrial natriuretic peptide (NT-proANP) levels were 1415.69 ± 213.05 and 1875.52 ± 241.02 ng/mL, the GDF-15 levels were 0.87 ± 0.43 and 1.21 ± 0.56 g/L, and the high-sensitivity C-reactive protein (hs-CRP) levels were 6.54 ± 1.56 and 8.77 ± 1.94 mg/L, respectively, with statistically significant differences (P < 0.05). The cumulative incidence of MACEs in the observation group was significantly lower than that in the control group (P < 0.05). The incidence of adverse reactions was 13.73% (7/51) in the observation group and 10.64% (5/47) in the control group, with no statistically significant difference (P > 0.05).

CONCLUSION

Dapagliflozin combined with nocinto can improve myocardial microperfusion and left ventricular remodeling and reduce MACE incidence in patients with post-AMI heart failure and T2DM. The underlying mechanism may be related to the reduction in the expression levels of NT-proANP, GDF-15, and hs-CRP.

Keywords: Dagelin; Nocinto; Acute myocardial infarction; Type 2 diabetes; Heart failure; Myocardial microperfusion

Core Tip: This study explored the efficacy of combining dapagliflozin and sakubactrovalsartan (noxinto) in improving myocardial microperfusion and reducing major adverse cardiovascular event incidence in patients with post–acute myocardial infarction (AMI) heart failure and type 2 diabetes mellitus (T2DM). Results indicated that compared with the control group, significant improvements in myocardial perfusion, blood glucose levels, and cardiac function along with reductions in N-terminal pro-atrial natriuretic peptide, growth differentiation factor-15, and high-sensitivity C-reactive protein levels were noted in the observation group. These findings revealed that this combination therapy may offer a novel approach for managing complex cases of post-AMI heart failure and T2DM, highlighting its potential benefits and mechanisms of action.