Clinical evaluation of dapagliflozin combined with spironolactone in the treatment of coronary heart disease complicated with HFrEF
JING Yu
GU Shunzhong
DING Hongsheng
LU Yang
LIU Zhiyun
JI Peng
YAN Yongjin
Abstract：Objective To investigate the clinical efficacy of dapagliflozin combined with spironolactone in the treatment of coronary heart disease(CHD)complicated by heart failure with reduced ejection fraction(HFrEF).Methods A prospective controlled study was adopted.A total of 156 patients with CHD complicated by HFrEF admitted to Hai'an People's Hospital from July 2023 to December 2024 were enrolled and randomly divided into the control group(foundational treatment plus spironolactone)and the experimental group(foundational treatment plus dapagliflozin combined with spironolactone),with 78 cases in each group.After attrition,74 cases per group were included in the final data analysis.Clinical efficacy,exercise tol-erance,ventricular remodeling indicators,blood pressure,blood glucose,blood biochemical markers,and incidence of adverse reactions were observed and compared between the two groups.Results After treatment,the total effective rate in the exper-imental group was 90.54%(67/74),significantly higher than 78.38%(58/74)in the control group(χ2=4.170,P<0.05).The ex-perimental group showed a greater improvement in the 6-minute walk test distance((378.48±31.58)m),higher than that in the control group((356.32±32.72)m)(t=4.192,P<0.05).Ventricular remodeling indicators,including left ventricular end-diastolic diameter,interventricular septal thickness,and left ventricular posterior wall thickness,were all lower in the experimental group compared to those in the control group((50.63±7.83),(9.67±1.62),(9.17±1.38)mm vs(55.42±6.41),(11.51±1.13),(11.73±2.56)mm),while left ventricular ejection fraction was higher in the experimental group((49.35±5.31)%vs(42.73±5.62)%)(t=4.072,8.014,7.572,7.365,all P<0.05).The experimental group also had lower levels of interleukin-6,C-reactive pro-tein,and N-terminal pro-brain natriuretic peptide((74.37±9.82)ng/L,(3.87±0.47)mg/L,(584.81±72.63)pg/mL vs(91.38±10.74)ng/L,(5.72±0.89)mg/L,(741.63±78.35)pg/mL)(t=10.055,15.812,12.627,all P<0.05).There were no significant dif-ferences in systolic blood pressure,diastolic blood pressure,and blood glucose parameters(fasting blood glucose,glycated hemoglobin)between the two groups(t=1.133,1.868,0.352,0.235,all P>0.05).The incidence of adverse reactions also showed no significant difference(5.41%(4/74)vs 9.46%(7/74),χ2=0.429,P>0.05).Conclusion Dapagliflozin combined with spirono-lactone can improve clinical efficacy,enhance cardiac function,and increase the quality of life in patients with CHD complicated by HFrEF,with a favorable safety profile.
Keywords：dapagliflozinspironolactonecoronary heart diseaseheart failure with reduced ejection fractioncardiac function
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：5( 176-180 )