Combined treatment with sacubitril/valsartan plus dapagliflozin in patients affected by heart failure with reduced ejection fraction

Jiang, Juan; Gao, Jie; Zhang, Xiuzhen; Li, Yuanmin; Dang, Heqin; Liu, Yanlin; Chen, Wenwen

doi:10.3389/fcvm.2023.1097066

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…To achieve this, we included four recently conducted clinical trials, namely the EMPIRE-HF trial, the DAPA-HF trials, and the EMPEROR-Reduced trial, along with three retrospective studies. The retrospective studies conducted by Hsiao et al, 16 Jiang et al, 17 and Karabulut et al 18 examined the impact of the combination of SGLT2i and ARNI The meta-analysis of the studies included in this research indicates that the combination of SV and SGLT2i is superior in reducing all-cause mortality, cardiac death outcomes, and hospitalization incidence.…”

Section: Discussionmentioning

confidence: 83%

“…To achieve this, we included four recently conducted clinical trials, namely the EMPIRE‐HF trial, the DAPA‐HF trials, and the EMPEROR‐Reduced trial, along with three retrospective studies. The retrospective studies conducted by Hsiao et al, 16 Jiang et al, 17 and Karabulut et al 18 examined the impact of the combination of SGLT2i and ARNI on patients with heart failure and reduced ejection fraction and DM. The studies concluded that this combination therapy was well‐tolerated among diabetic patients with HFrEF and was linked to a reduced risk of hospitalization due to heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…Abstracts, studies without enough data for a 2 × 2 table, and related research that did not meet the inclusion criteria were all disqualified from inclusion in the present study. Two writers (X. M. and P. L.) independently searched the appropriate databases for relevant studies, while X. Y. researcher worked separately to extract the characteristics of the included studies 16 , 17 , 18 , 19 , 20 , 21 , 22 and event data with key variables. Through discussions, differences of opinion were reconciled.…”

Section: Methodsmentioning

confidence: 99%

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Efficacy of sacubitril‐valsartan and SGLT2 inhibitors in heart failure with reduced ejection fraction: A systematic review and meta‐analysis

Lü

Yang

2023

Clinical Cardiology

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BackgroundSacubitril‐valsartan (SV) monotherapy has been shown to help patients with Heart failure with reduced ejection fraction (HFrEF), but whether adding a sodium‐glucose cotransporter‐2 inhibitor (SGLT2i) improves treatment results even more is unknown.HypothesisThe goal of this study was to look at the efficacy of SV with additional SGLT2i in HFrEF patients.MethodsFor this study, several databases, such as PubMed, EMBASE, Web of Science, and the Cochrane Library, were searched. A coherent search approach was used for data extraction. Review Manager 5.2 and MedCalc were used for conducting the meta‐analysis and bias analysis. A meta‐regression study correlates patient mean age with primary and secondary outcomes.ResultsSeven trials totaling 16 100 patients were included in this meta‐analysis. All‐cause mortality, cardiovascular mortality, and improvement in mean left ventricular ejection fraction (LVEF) were the study's major objectives, while hospitalization for heart failure (HF) was calculated to be its secondary outcome. Our analysis showed that HFrEF patients receiving the combination of SV and SGLT2i had better treatment outcomes than the standard SV monotherapy, with risk ratios of 0.76 (0.65–0.88) for all‐cause mortality, 0.65 (0.49–0.86) for cardiovascular mortality, 1.41 (−0.59 to 3.42) for change in mean LVEF, and 0.80 (0.64–1.01) for hospitalization for HF. According to the regression analysis, older HFrEF patients have higher rates of hospitalization, cardiovascular disease, and overall death.ConclusionsThe combination of SV and SGLT2i may have a greater cardiovascular protective effect and minimize the risk of death or hospitalization due to heart failure in HFrEF.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Efficacy of sacubitril‐valsartan and SGLT2 inhibitors in heart failure with reduced ejection fraction: A systematic review and meta‐analysis

Lü

Yang

2023

Clinical Cardiology

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“…Few studies have compared the efficacy of S/V and DAPA alone and in combination in post-MI patients with HF. A correlational investigation revealed that patients with HFrEF who received combination therapy with DAPA and S/V demonstrated notably enhanced cardiovascular benefits in comparison to those in individuals receiving monotherapy with S/V ( 31 ). In addition, the effects of the co-administration of S/V and DAPA surpassed those of monotherapy in protecting the rat myocardium against ischemia-reperfusion (I/R) injury ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Optimal treatment for post-MI heart failure in rats: dapagliflozin first, adding sacubitril-valsartan 2 weeks later

Tao

Yang

Zhang

et al. 2023

Front. Cardiovasc. Med.

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BackgroundBased on previous research, both dapagliflozin (DAPA) and sacubitril-valsartan (S/V) improve the prognosis of patients with heart failure (HF). Our study aims to investigate whether the early initiation of DAPA or the combination of DAPA with S/V in different orders would exert a greater protective effect on heart function than that of S/V alone in post-myocardial infarction HF (post-MI HF).MethodsRats were randomized into six groups: (A) Sham; (B) MI; (C) MI + S/V (1st d); (D) MI + DAPA (1st d); (E) MI + S/V (1st d) + DAPA (14th d); (F) MI + DAPA (1st d) + S/V (14th d). The MI model was established in rats via surgical ligation of the left anterior descending coronary artery. Histology, Western blotting, RNA-seq, and other approaches were used to explore the optimal treatment to preserve the heart function in post-MI HF. A daily dose of 1 mg/kg DAPA and 68 mg/kg S/V was administered.ResultsThe results of our study revealed that DAPA or S/V substantially improved the cardiac structure and function. DAPA and S/V monotherapy resulted in comparable reduction in infarct size, fibrosis, myocardium hypertrophy, and apoptosis. The administration of DAPA followed by S/V results in a superior improvement in heart function in rats with post-MI HF than those in other treatment groups. The administration of DAPA following S/V did not result in any additional improvement in heart function as compared to S/V monotherapy in rats with post-MI HF. Our findings further suggest that the combination of DAPA and S/V should not be administered within 3 days after acute myocardial infarction (AMI), as it resulted in a considerable increase in mortality. Our RNA-Seq data revealed that DAPA treatment after AMI altered the expression of genes related to myocardial mitochondrial biogenesis and oxidative phosphorylation.ConclusionsOur study revealed no notable difference in the cardioprotective effects of singular DAPA or S/V in rats with post-MI HF. Based on our preclinical investigation, the most effective treatment strategy for post-MI HF is the administration of DAPA during the 2 weeks, followed by the addition of S/V to DAPA later. Conversely, adopting a therapeutic scheme whereby S/V was administered first, followed by later addition of DAPA, failed to further improve the cardiac function compared to S/V monotherapy.

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“…In recent years, studies have investigated the efficacy of sacubitril/valsartan combined with other medications in patients with CHF, but there are few data on the combination of this drug regimen with LBBP. 9 , 10 Therefore, we conducted a retrospective analysis of the clinical data of patients with CHF who received LBBP combined with enalapril or sacubitril/valsartan treatment in our hospital, with the aim of clarifying their specific intervention outcomes. We believe that our results may be useful as a reference for caregivers to select optimal treatment plans for their patients with CHF.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the efficacy of combining left bundle branch pacing with either sacubitril/valsartan or enalapril in the treatment of chronic heart failure: A retrospective observational analysis

Wang,

Feng,

Sun

et al. 2023

Pak J Med Sci

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Objective: To assess the efficacy of left bundle branch pacing (LBBP) combined with either sacubitril/valsartan or enalapril in the treatment of chronic heart failure (CHF). Methods: We retrospectively reviewed the records of 138 patients with CHF admitted to Dazhou Central Hospital between June 2020 and June 2022 to extract clinical data. We divided the data into two treatment groups for the analysis: 71 patients received LBBP combined with sacubitril/valsartan treatment (sacubitril/valsartan group), and 67 received LBBP combined with enalapril treatment (enalapril group). The levels of cardiac and cardiopulmonary function indicators, levels of myocardial injury markers, and the scores of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) before and after the treatment were compared between the two groups. Results: After six months of treatment, patients in the sacubitril/valsartan group had lower myocardial injury markers, higher cardiopulmonary function indicators, and lower MLHFQ scores (P<0.05). Conclusions: In CHF patients, the combination of LBBP with sacubitril/valsartan had a better therapeutic effect compared to LBBP with enalapril, with more effective improvement of the cardiopulmonary function, reduction of myocardial injury, and improvement in quality of life. doi: https://doi.org/10.12669/pjms.40.3.8520 How to cite this: Wang S, Feng Y, Sun X, Gou H, Guo Y. Comparison of the efficacy of combining left bundle branch pacing with either sacubitril/valsartan or enalapril in the treatment of chronic heart failure: A retrospective observational analysis. Pak J Med Sci. 2024;40(3):---------. doi: https://doi.org/10.12669/pjms.40.3.8520 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Combined treatment with sacubitril/valsartan plus dapagliflozin in patients affected by heart failure with reduced ejection fraction

Cited by 4 publications

References 41 publications

Efficacy of sacubitril‐valsartan and SGLT2 inhibitors in heart failure with reduced ejection fraction: A systematic review and meta‐analysis

Efficacy of sacubitril‐valsartan and SGLT2 inhibitors in heart failure with reduced ejection fraction: A systematic review and meta‐analysis

Optimal treatment for post-MI heart failure in rats: dapagliflozin first, adding sacubitril-valsartan 2 weeks later

Comparison of the efficacy of combining left bundle branch pacing with either sacubitril/valsartan or enalapril in the treatment of chronic heart failure: A retrospective observational analysis

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