Effects of Dapagliflozin in Combination with Metoprolol Sustained-Release Tablets on Prognosis and Cardiac Function in Patients with Acute Myocardial Infarction after PCI

Abstract

Objective. To find the effects of dapagliflozin in combination with metoprolol sustained-release tablets on cardiac function and prognosis in acute myocardial infarction patients after PCI. Methods. A total of 84 patients with myocardial infarction who experienced PCI from February 2020 to February 2022 were included and allocated into 3 groups: groups A, B, and C ( n = 28 /per group). Group A was given dapagliflozin combined with metoprolol sustained-release tablets, group B was given dapagliflozin, and group C was given the placebo. Left ventricular end diastolic diameter (EDD), left ventricular ejection fraction (LVEF), and end systolic diameter (ESD) were measured before and after treatment in all groups; myocardial infarction areas were matched among all three groups at 3 months posttreatment. The serum concentrations of interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), superoxide dismutase (SOD), and malondialdehyde (MDA) were detected in all three groups before and after treatment. The levels of N-terminal probrain natriuretic peptide (NT-pro BNP), lipoprotein (a) (Lp(a)), ischemia-modified albumin (IMA), and secreted frizzled-related protein 5 (SFRP5) were also detected in the serum of all groups. Adverse reactions and cardiovascular adverse events were matched between all groups. Results. The levels of LVEF in groups A and B were increased after treatment, while the levels of EDD and ESD were decreased. The improvement degree of LVEF and EDD levels in groups A and B was found greater compared to group C ( P < 0.05 ). No significant difference was found in myocardial infarction area among the three groups at 3 months postoperation ( P > 0.05 ). Serum concentrations of MDA, hs-CRP, IL-6, IMA, NT-proBNP, and Lp(a) were found to decrease in all three groups after treatment, while the levels of SOD and SFRP5 were increased. The improvement degree of serum hs-CRP, IL-6, SOD, MDA, IMA, NT-proBNP, Lp(a), and SFRP5 levels was greater in both groups A and B compared to group C. The improvement degree of serum hS-CRP, SOD, MDA, IMA, Nt-probNP, Lp(a), and SFRP5 levels was significantly greater in group A compared to group B ( P < 0.05 ). No adverse effect was observed in all three groups ( P > 0.05 ). Total occurrence of cardiovascular adverse effects such as stent thrombosis, heart failure, ventricular fibrillation, and death was 10.71% in group A, 25.00% in group B, and 53.75% in group C. There was statistical significance in the onset of cardiovascular adverse effects 3 months postoperation among all three groups ( P < 0.05 ). Conclusion. Dapagliflozin with metoprolol sustained-release tablets can be effective in improving the heart function, inflammatory response, oxidative stress response, and prognosis in patients after PCI.

Assessing the early prognosis of heart failure after acute myocardial infarction using left ventricular pressure-strain loop: a prospective randomized controlled clinical study

“…Moreover, it was the first drug to be recommended for use in all phases of HF. However, relatively few studies have assessed the role of dapagliflozin in the treatment of P-MI-HF ( 19 , 20 ). Thus, we conducted this study to assess the early prognosis of patients with P-MI-HF treated with dapagliflozin plus sacubitril/valsartan vs. sacubitril/valsartan alone using the LV-PSL technique.…”

Long-Term Trajectories of Biomarkers, Functional, and Echocardiographic Parameters in Patients with Chronic Heart Failure from Dilated or Ischaemic Cardiomyopathy

“…A reduction in LVIDD over time may indicate decongestion and/or reverse remodelling in response to HF treatment. Studies have shown a reduction of LVIDD in response to treatment with sacubitril/valsartan, dapagliflozin, eplerenone, or valsartan for up to 22 months [27][28][29][30][31]. Given the differences in LVIDD reduction in DCM versus ICM, it is possible that current optimal medical therapy produces more favourable ventricular remodelling in DCM patients.…”

Effects of new hypoglycemic drugs on cardiac remodeling: a systematic review and network meta-analysis

“…We evaluated the quality of the included studies for assessing the risk of bias. 6 studies were designed as open-label [22,24,29,39,42,43]. Among those open-label studies, 2 studies were judged to have high risk of selective reporting bias.…”

“…Among those open-label studies, 2 studies were judged to have high risk of selective reporting bias. One article did not specify the method of randomization [42], and the other article reported more than 20% of total withdrawals during follow-up, but did not mention the speci c reasons [29]. Four studies were cohort studies and were rated high quality according to NOS scores.…”