| Objective:Chronic Heart failure(CHF)affects millions of patients worldwide and is widely regarded as a major problem affecting human health.The gradual increase in the prevalence of CHF will bring a huge economic and spiritual burden to the society and patients.With the more in-depth research on the causes and mechanisms of CHF patients,the significant progress has been made in the treatment of CHF,and more and more new drugs are being developed.This study aims to discuss the effectiveness and safety of drug therapy for patients with CHF in actual clinical practice.Methods:By consulting the medical record information of patients with chronic heart failure admitted from October 2017 to February 2020 in the electronic medical record system of our hospital,815 patients with chronic heart failure were finally included according to the inclusion and exclusion criteria.According to the drug usage of the patients,they were divided into four groups:A,B,C,and D,namely the irregular treatment group(250 cases),the "Golden Triangle" treatment group(250 cases),the sacubitril/valsartan treatment group(200 cases),and dapagliflozin treatment group(115 cases).The general data collected from patients include age,gender,smoking history,drinking history,disease history,and heart rate,blood pressure,liver and kidney function,blood ions,urine routine,Brain Natriuretic Peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),and the number of hospitalizations within one year before and 1 year after medication.A retrospective analysis method was used to compare and analyze the effectiveness and safety of drug treatment among the four groups.SPSS 26.0 statistical software was used to analyze the collected data.If the measurement data obey the normal distribution,one-way analysis of variance shall be used to compare the differences between the groups,and the data shall be expressed in the form of "mean±standard deviation".The measurement data subjecting to non-normal distribution should be compared with each other by non-parametric tests,which are expressed in the form of"median(Q1,Q3)".The count data are uniformly expressed as "cases(rate)",and the chi-square test is used to compare the differences between groups.When P<0.05,the difference is considered to be statistically significant.Results:1.General clinical data:The four groups of patients were compared in terms of age,gender,smoking history,drinking history,hospitalized cardiac function classification(NYHA classification),comorbidities other than diabetes and other general data,and the differences were not statistically significant(P>0.05).The diabetes history of the four groups was significantly different(P<0.05),and the prevalence of diabetes in group D was significantly higher than that in groups A,B,and C.2.Comparison of heart rate before and after treatment:After treatment,the heart rate of all groups was slower than that the before treatment,and the heart rate of groups C and D slowed down more significantly than that of groups A and B.There is no statistically significant difference between group A and group B,group C and group D(P>0.05);While groups C and D were compared groups A and B,respectively,the difference was statistically significant(P<0.05).3.Comparison of blood pressure before and after treatment:After treatment,the systolic blood pressure(SBP)and diastolic blood pressure(DBP)of the all groups were lower than that the before treatment,where the reduction in SBP and DBP of groups C and D was more significant than that of groups A and B.There is no statistically significant difference between group A and group B,group C and group D(P>0.05);While groups C and D were compared groups A and B,respectively,the difference was statistically significant(P<0.05).4.Comparison of serum BNP before and after treatment:The BNP of all groups were lower than that the before treatment,the reduction in BNP of C and D groups was more significant than that of A and B groups.There is no statistically significant difference between group A and group B,group C and group D(P>0.05);While groups C and D were compared groups A and B,respectively,the difference was statistically significant(P<0.05).5.Comparison of LVEF and LVEDD before and after treatment:In terms of LVEF,the LVEF of groups A and B were lower than that the before treatment,and the LVEF of groups C and D were higher than that the before treatment.There is no statistically significant difference between group A and group B,group C and group D(P>0.05);While groups C and D were compared groups A and B,respectively,the difference was statistically significant(P<0.05).In terms of LVEDD,the LVEDD of groups A and B were higher than that the before treatment,and the LVEDD of groups C and D were lower than that the before treatment.There was no statistically significant difference between group A and group B,and group D with group A,B,and C,respectively(P>0.05);Comparing group C with groups A and B,respectively,the difference was statistically significant(P<0.05).6.Comparison of the number of hospitalizations within 1 year:The number of hospitalizations in groups C and D within 1 year was significantly less than that in groups A and B.There is no statistically significant difference between group A and group B,and between group C and group D(P>0.05);Comparing groups C and D with groups A and B,respectively,the difference was statistically significant(P<0.05).7.Medication safety:There was no statistically significant difference in Alanine Aminotransferase(ALT),Aspartate Aminotransferase(AST),Creatinine(Cr),Blood Urea Nitrogen(BUN)between the four groups after treatment(P>0.05).8.Adverse reactions:There was no statistically significant difference between the four groups with hypotension,hyperkalemia,and urinary tract infection after medication(P>0.05).Conclusion:1.The use of sacubitril/valsartan and dapagliflozin can improve the heart function of patients,reduce plasma BNP concentration,increase the left ventricular ejection fraction,and reduce the number of hospitalizations;sacubitril/valsartan can reverse Ventricular remodeling,while dapagliflozin did not significantly improve ventricular remodeling.2.There is no difference in the effects of sacubitril/valsartan and dapagliflozin on heart failure.3.There was no difference in medication safety and adverse reactions among the four groups. |
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