Clinical evaluation of dapagliflozin combined with tolvaptan in patients with coronary heart disease and heart failure
ZHOU Libin
QIAO Fubin
ZHANG Xiaoqiang
HE Yanli
XUE Hong
Abstract：Objective To investigate the effect of dapagliflozin combined with tolvaptan on the treatment of coronary heart disease(CHD)and heart failure(HF),and the impacts on patients'exercise tolerance and cardiac function.Methods A total of 110 patients with CHD and HF admitted to Xingtai General Hospital of North China Medical and Health Group from May 2023 to May 2024 were selected and divided into the control group and the study group by the random number table meth-od,with 55 cases per group.The control group received conventional intervention plus tolvaptan treatment,while the study group received conventional intervention plus tolvaptan and dapagliflozin treatment.The total effective rate,cardiac function in-dicators,serum biochemical indicators,exercise tolerance,quality of life,and adverse reactions were compared between the two groups.Results The total effective rate of the study group was 87.27%(48/55),higher than that of the control group(69.09%(38/55))(χ2=5.329,P＜0.05).The left ventricular ejection fraction and the levels of tissue inhibitor of matrix metalloproteinase 4 and 6-minute walk test in the study group were higher than those in the control group((52.28±6.43)%vs(46.37±5.56)%,(129.22±15.75)μg/L vs(97.68±11.36)μg/L,(397.11±42.56)m vs(366.25±38.65)m)(t=5.156,12.045,3.981,all P＜0.05).The left ventricular end systolic diameter,the level of free fatty acid,Minnesota Living with Heart Failure Questionnaire scores,and left ventricular end diastolic diameter were lower than those in the control group((39.33±4.04)mm vs(42.52±4.66)mm,(0.42±0.09)mmol/L vs(0.61±0.13)mmol/L,(47.25±5.75)points vs(56.88±6.58)points,(47.77±4.96)mm vs(51.34±5.51)mm)(t=3.836,8.912,8.173,3.571,all P＜0.05).There was no statistically significant difference in the incidence of gastrointestinal reactions and angioedema between the study group and the control group(9.09%(5/55)vs 3.64%(2/55))(Fisher's exact test,P=0.242).Conclusion The combination of dapagliflozin and tolvaptan demonstrates good efficacy in treating patients with CHD and HF.It can enhance ventricular ejection capacity and protect cardiac function.
Keywords：heart failurecoronary heart diseasedapagliflozintolvaptancardiac function
Publication Date：2025-12-25
Online Publishing Date：2026-01-07(First online date of this platform, not the publication date of the document)
Pages：4( 1465-1468 )