Clinical Study Of Dapagliflozin In Elderly Female Patients With HFpEF Combined With T2DM

Objective:To investigate the effects of dapagliflozin on cardiac ultrasound parameters,quality of life scores,hs-CRP,NT-pro BNP,drug safety,and readmission rates in elderly women with HFp EF combined with T2 DM.Methods:Patients who met the inclusion criteria were divided into in the control group and in the dapagliflozin group according to the dosing regimen.The dapagliflozin group was administered with dapagliflozin 10 mg qd.Patients were followed up for changes in hsCRP and NT-pro BNP levels before,3,6 and 12 months after dosing,and for cardiac function parameters,drug safety(including effects on renal and liver function)and readmission rates due to heart failure,to analyze the effects of dapagliflozin on patients’ cardiac function.Echocardiographic parameters included: LVEDVI,LVESVI,LVMI,LAVI,MLHFQ.The MLHFQ was used to evaluate patients’ quality of life.Patients were compared for changes in cardiac function before treatment,at 3,6 and 12 months of treatment,observed for adverse drug reactions,and readmission rates were calculated.Significant univariate variables were subjected to multifactorial analysis.Results:1.A total of 183 subjects were included in this study,5 of whom were lost to followup.A total of 178 patients were finally followed up,with an average age of(72.25±4.93)years.Compared with before treatment,LAVI,LVMI and MLHFQ scores in 2 groups were significantly decreased at 3,6 and 12 months of treatment,with statistical significance(P<0.05).Compared with the control group,LAVI and LVMI in dapagliflozin group were significantly decreased at 3,6 and 12 months(P<0.05);Compared with the control group,MLHFQ score of dapagliflozin group was significantly decreased at 3 and 6 months after treatment(P<0.05).2.Compared with pre-treatment,hs-CRP and NT-pro BNP levels were significantly lower in both groups at 3,6 and 12 months of treatment,with statistically significant differences(P<0.05);compared with the control group,the dapagliflozin group had lower NT-pro BNP levels at 3,6 and 12 months of treatment(P<0.05);Compared with the control group,the hs-CRP level of dapagliflozin group was significantly decreased at 3 and 6months(P<0.05).3.There were 11(12.64%)and 23(25.27%)readmissions due to heart failure in the dapagliflozin and control groups at 12 months of follow-up,respectively.Kaplan-Meier survival analysis of readmission rates in the dapagliflozin and control groups showed a statistically significant difference in cumulative survival rates between the two groups(P=0.035).4.Univariate analysis of HFp EF patients with T2 DM patients with heart failure readmission: ACEI/ARB,dapagliflozin and LVMI were all correlated with readmission(P<0.05).Multivariate COX regression analysis showed that ACEI or ARB,dapagliflozin could reduce the risk of readmission in elderly women with HFp EF patients with T2 DM.LVMI maybe associated with readmission.5.During the follow-up period,no serious adverse reactions occurred in either group.During the 12-month follow-up period,five and three urinary tract infections occurred in the dapagliflozin and control groups,respectively,with no statistical significance(P>0.05).Conclusions:1.Dapagliflozin can improve cardiac function,significantly reduce LAVI and LVMI indicators,improve quality of life,and reduce MLHFQ score in elderly women with HFp EF combined with T2 DM.2.Dapagliflozin can reduce hs-CRP levels,reduce oxidative stress,lower NT-pro BNP levels,improve prognosis,and reduce readmission rates in such patients.3.Dapagliflozin has no obvious adverse reactions while improving the cardiac function of patients,and has little effect on renal function,showing good safety.