The efficacy and economic analysis of dapagliflozin combined with sacubitril-valsartan in treating left heart failure-associated pulmonary arterial hypertension

Li Na; Gong Lihua; Song Bei; Cheng Xiaoying

doi:10.3969/j.issn.1002-1949.2025.10.009

Abstract：Objective To observe the efficacy of dapagliflozin combined with sacubitril-valsartan(Entresto)in treating left heart failure-associated pulmonary arterial hypertension(LHF-PAH)and conduct an economic analysis.Methods A total of 100 LHF-PAH patients admitted to Handan First Hospital from June 2021 to October 2023 were included and randomly assigned to two groups:a single group(n=50,heart failure symptomatic treatment+Entresto)and a combined group(n=50,single group regimen plus dapagliflozin).The cardiac function indicators[left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)],plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP),6-minute walking test(6MWT)distance,mean pulmonary artery pressure(MPAP),occurrence of major adverse cardiac events(MACE),efficacy and cost-effectiveness ratio(C/E)were compared between the two groups.Results After 6-month treatment,LVESD and LVEDD in both groups were smaller than those before treatment,and the combined group was smaller than the single group(P<0.05);LVEF and 6MWT in both groups were higher than those before treatment(P<0.05),and the combined group was higher than the single group(P<0.05);The plasma NT-proBNP level and MPAP in both groups was lower than those before treatment(P<0.05),and the combined group was lower than the single group(P<0.05).There was no difference in the incidence of MACE between the combined group(4.17%)and the single group(14.89%)(P>0.05).The total effective rate of the combined group was 95.83%,which was higher than 76.60%in the single group(P<0.05).The C/E of the combined group was 45.66 RMB yuan,which was lower than 46.07 RMB yuan of the single group.Conclusions The combination of dapagliflozin and Entresto has a better effect on LHF-PAH,can effectively improve heart function,obviously reduce MPAP,can obviously enhance exercise endurance and is cost-effective.