Efficacy of dapagliflozin combined with metformin in patients with type 2 diabetes mellitus and heart failure with reduced ejection fraction
DI Fangfang
LIU Shengrui
YAO Wanchen
LI Shasha
LI Yuanyuan
Abstract：Objective To explore the effect of dapagliflozin combined with metformin on patients with type 2 dia-betes mellitus(T2DM)and heart failure of reduced ejection fraction(HFrEF).Methods A total of 160 patients with T2DM complicated with HFrEF who were admitted to Department of Emergency and Critical Care Medicine of The People's Hospital of Langfang City from January 2020 to December 2023 were selected and divided into the metformin group(n=80,treated with the conventional anti-heart failure plus metformin)and the dapagliflozin combination group(n=80,treated with dapagliflozin on the basis of the metformin group)by using the computer-generated random number table method.All the patients in both groups were treated for 1 month.The clinical efficacy,glucose metabolism indexes(fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),homeostasis model assessment-insulin resistance index(HOMA-IR)),serum biochemical indexes(cystatin C(CysC),N-terminal pro-brain natriuretic peptide(NT-proBNP)),ventricular remodeling parameters(left ventricular end-dia-stolic volume index(LVEDVI),left ventricular end-systolic volume index(LVESVI),left ventricular mass index(LVMI),left ventricular remodeling index(LVRI))and major adverse cardiovascular events(MACE)were compared between the two groups.Results The total effective rate was 97.50%(78/80)in the dapagliflozin combination group and 86.25%(69/80)in the metformin group(χ2=4.353,P<0.05).After treatment,the levels of FPG,2hPG,HOMA-IR,CysC and NT-proBNP in the the dapagliflozin combination group were(7.18±1.52)mmol/L,(9.11±1.47)mmol/L,(2.77±0.46),(1.08±0.27)mg/L and(1 805.27±320.46)pg/mL,lower than those before treatment((9.48±2.46)mmol/L,(12.74±3.28)mmol/L,(4.98±0.87),(2.76±0.76)mg/L,(2 257.08±526.84)pg/mL),and the above indexes in the dapagliflozin combination group were lower than those in the metformin group(all P<0.05).The levels of LVEDVI,LVESVI,LVMI and LVRI in the dapagliflozin combination group were(47.18±1.15)mL/m2,(31.54±2.59)mL/m2,(109.54±14.28)g/m2 and(1.98±0.14)g/mL,lower than those before treatment((52.69±2.61)mL/m2,(37.49±2.54)mL/m2,(124.59±25.36)g/m2,(2.79±0.64)g/mL),and the above indexes in the dapagliflozin combination group were lower than those in the metformin group(all P<0.05).There was no significant difference in the incidence of MACE between the dapagliflozin combination group and the metformin group(11.25%(9/80)vs 8.75%(7/80),χ2=0.278,P>0.05).Conclusion Dapagliflozin combined with metformin can improve glucose metabolism,cardiac and renal function,and reverse ventricular remodeling in patients with T2DM and HFrEF.
Keywords：dapagliflozinmetformintype 2 diabetes mellitusventricular remodelingmajor adverse cardiovascular events
Publication Date：2026-03-25
Online Publishing Date：2026-04-07(First online date of this platform, not the publication date of the document)
Pages：5( 382-386 )