Clinical Effects of Sacubitril/Valsartan Combined with Dapagliflozin in Patients with Diabetes and ST-segment Elevation Myocardial Infarction

Abstract

Objectives: This study was aimed at observing the clinical effects of sacubitril/valsartan combined with dapagliflozin on cardiac function and ventricular remodeling in patients with type 2 diabetes and ST-segment elevation myocardial infarction (STEMI). Methods: Between May 2019 and May 2022, we retrospectively analyzed 57 patients with diabetes and STEMI receiving percutaneous coronary intervention: 32 patients receiving sacubitril/valsartan and dapagliflozin tablets comprised the observation group and 25 patients receiving angiotensin converting enzyme inhibition (ACEI) or angiotensin receptor blockers ARB) in combination with other hypoglycemic drugs comprised the control group. We compared the left ventricular end diastolic diameter (LVEDD), right ventricular end diastolic diameter (RVEDD), left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-pro BNP), and noninvasive hemodynamic parameters at baseline and 3–6 months after treatment between the groups. Results: Before treatment, the parameters were similar between the observation group and control group. However, after 3−6 months of treatment, serum NT-pro BNP levels showed a greater decline in the observation group than the control group. Moreover, the LVEDD and LVEF improved more substantially in the observation group than the control group (P<0.05). RVEDD did not markedly change after treatment (P>0.05). After treatment, in the observation group, the cardiac index (CI) and cardiac output (CO) were significantly higher, and the thoracic fluid conduction (TFC) and systemic vascular resistance index (SVRI) were significantly lower, than those in the control group (P<0.05). Conclusions: Sacubitril/valsartan combination with dapagliflozin exerted better effects than ACEI or ARB with other hypoglycemic drugs in improving cardiac function and ventricular remodeling in patients with diabetes and STEMI.