Short-term Observation Of Clinical Efficacy And Safety Of Dagliazine Combined With Shakubactrivalsartan In Elderly Patients With Ischemic Heart Failure

Objective: The incidence of heart failure with ischemic heart disease is high,and the treatment of this kind of patients is still a difficult problem for clinicians.Shakubactrivalsartan and Daglipurine are two new drugs that have been shown to reduce clinical events in patients with chronic heart failure.Dagliazine was listed late in China,and its clinical application is still in its initial stage.There is little drug experience for patients with ischemic heart disease and elderly patients with heart failure.Therefore,by observing the clinical efficacy and safety of dagliazine combined with sacubactrivalsartan in elderly patients with heart failure caused by ischemic heart disease and complete revasectomy,this study discussed the efficacy and safety of early application of Dagliazine,providing more clinical basis for the application of Dagliazine.Methods: A total of 254 elderly patients with heart failure who received complete revascularization therapy due to ischemic heart disease with reduced ejection fraction were analyzed from September 2020 to June 2022 in Liaoning Provincial People’s Hospital.According to drug use,patients were divided into control group and observation group,with 130 cases in control group and 124 cases in observation group.The control group was treated with β-receptor blockers,spironolactone and sakubactrivalsartan,and the observation group was treated with dagliazine on the basis of the control group’s medication for 6 months.Basic clinical data including age,sex,body mass index(BMI),smoking history,systolic blood pressure,heart rate,co-existing diseases,laboratory indicators,New York Heart Association(NYHA)grading,and medication were collected.Left ventricular function indexes(left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),cardiac output(CO) (calculated based on stroke output measured by cardiac ultrasound),laboratory indexes serum N-terminal natriuretic peptide precursor(NT-pro BNP),C-reactive protein(CRP)were collected.6-minute walking distance(6MWD)and the results of the review after 6months.Major adverse reactions such as hypotension,hypoglycemia,abnormal renal function and angioedema were recorded in the two groups during treatment.The changes of LVEF,LVEDV,CO,NT-pro BNP,CRP and 6MWD and the differences of adverse reactions were compared between the two groups before and after treatment.Results:1.A total of 254 patients were included in this study for research analysis,including130 patients in the control group and 124 patients in the observation group.There were no significant differences in age,sex,BMI,smoking history,systolic blood pressure,heart rate,co-existing diseases,laboratory indexes,NYHA grade,drug use and other basic clinical data between 2 groups(P > 0.05).2.Before treatment,there was no significant difference in left heart function indexes including LVEF,LVEDV and CO between the observation group and the control group(P > 0.05).After 6 months of treatment,LVEF,LVEDV,CO and other indicators in 2 groups were improved compared with before treatment,the difference was statistically significant(P < 0.05),and the difference between 2 groups was statistically significant(P < 0.05).3.Before treatment,there was no statistical significance in laboratory indexes NT-pro BNP and CRP between the observation group and the control group(P > 0.05).After 6 months of treatment,the indexes of NT-pro BNP and CRP in the two groups were improved compared with those before medication,the difference was statistically significant(P < 0.05),and the difference between the two groups was statistically significant(P < 0.05).4.Before treatment,there was no significant difference in 6MWD between observation group and control group(P > 0.05).After 6 months of treatment,6MWD in both groups was improved compared with before treatment,the difference was statistically significant(P < 0.05),and the difference between the two groups was statistically significant(P < 0.05).5.The main adverse reactions such as hypotension,hypoglycemia,abnormal renal function and angioedema were recorded between the control group and the observation group,and there was no statistical difference in the incidence of major adverse reactions between the two groups(P > 0.05).Conclusion: Dagliazine combined with Shacubactrivalsartan can further improve left heart function in elderly patients with ischemic heart failure,reduce inflammatory response and oxidative stress response,improve myocardial ischemia and hypoxia status,improve functional status and exercise tolerance,and is safe and has clinical application value.