Short-term prognosis and influencing factors of dapagliflozin treatment in patients with chronic heart failure
ZHEN Yuan-yuan
XIA Yi-miao
SUN Yan-yan
DAI Zhong-li
WANG Fang
WANG Fa-cai
Abstract：Objective To investigates the current application of dapagliflozin in patients with chronic heart failure(CHF),evaluating the short-term prognosis of dapagliflozin treatment and identifying relevant influencing factors.Methods A retrospective study was conducted with 371 CHF patients treated between January 2022 and January 2023.Clinical characteristics and dapagliflozin treatment data were collected,and patients were followed for one year to monitor prognosis.The primary endpoints included heart failure rehospitalization and renal insufficiency.Patients were divided into a dapagliflozin group and a control group,with Kaplan-Meier analysis to assess short-term outcomes,and Cox regres-sion to identify independent predictors of combined endpoints(heart failure rehospitalization and renal insufficiency).Results Among the CHF patients studied,dapagliflozin was prescribed in 35.9％of cases.Patients in the dapagliflozin group had a significantly higher incidence of type 2 diabetes(P＜0.01)and hyperlipidemia(P=0.02)and a lower inci-dence of atrial fibrillation(P＜0.01)compared to controls.The dapagliflozin group was more likely to receive ACEI/ARB/ARNI(P＜0.01),MRA(P＜0.01),antiplatelet drugs(P=0.02),loop diuretics(P＜0.01),and antidiabetic drugs(P＜0.01),whereas the control group more frequently received NOAC(P＜0.01).Laboratory analyses showed higher serum albumin(P=0.02),fasting blood glucose(P＜0.01),and hemoglobin levels(P＜0.01)in the dapagli-flozin group.Kaplan-Meier analysis showed no significant difference between groups in heart failure rehospitalization(P=0.17);however,the risk of renal insufficiency was significantly lower in the dapagliflozin group(Log-Rank:x2=4.4,P=0.036).Cox regression analysis indicated that dapagliflozin(HR=0.624,P=0.034)significantly improved short-term prognosis,while triglycerides(HR=1.374,P=0.025)were an independent risk factor for prognosis.Con-clusion The clinical application of dapagliflozin in CHF patients shows a gap from guideline recommendations.Dapagli-flozin reduces the risk of renal insufficiency in CHF patients,emphasizing its potential role in heart failure management and renal protection.
Keywords：chronic heart failuredapagliflozinprognosis
Publication Date：2024-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 1577-1583 )