Efficacy of recombinant human brain natriuretic peptide combined with dapagliflozin in treatment of left heart failure after interventional surgery in elderly patients with acute myocardial infarction

CHEN Yanmei; JI Yueping; ZHOU Hong; LIU Man; FENG Ying

doi:10.3969/j.issn.1009-0126.2026.01.004

Abstract：Objective To explore the efficacy of combined recombinant human brain natriuretic peptide(rhBNP)and dapagliflozin in the treatment of left heart failure(HF)after interventional therapy in elderly patients with acute myocardial infarction(AMI).Methods A total of 120 elderly patients with left HF after AMI interventional surgery admitted to our department from July 2023 to July 2024 were enrolled and randomly classified into an observation group(60 cases)and a control group(60 cases).Both groups were given conventional anti-HF treatment,and the control group was treated with rhBNP,whereas the observation group was given with rhBNP and dapagliflozin.The cardiac function[N-terminal pro-B-type natriutetic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVESD)],serum indicators[myoglobin(MYO),cardiac troponin I(cTnI),aldosterone,norepinephrine(NE)]and exercise capacity[6-minute walking distance(6MWD)]were compared between groups and before treatment and after 3 months of treatment.The adverse reactions during treatment and the incidence of major adverse cardiac events(MACE)within 6 months after discharge were analyzed in both groups.Results After treatment,the NT-proBNP,LVESD,LVEDD,MYO,cTnI,aldosterone and NE were significantly reduced while the LVEF was significantly increased in the two groups compared to before treatment(P<0.05),and the NT-proBNP,LVESD,LVEDD,MYO,cTnI,aldosterone and NE were significantly lower,while the LVEF was significantly higher in the observation group after treatment than those in the control group(P<0.01).The 6MWD results after treatment were significantly higher in the observation group and the control group than those before treatment(384.62±23.37 m vs 256.48±20.42 m,354.25±24.02 m vs 258.03±21.37 m,P<0.01),and the observation group had obviously better 6MWD results after treatment than the control group(P<0.01).During treatment,no statistical differences were observed in the incidence rates of gastrointestinal reactions,hypotension,hypoglycemia and urinary tract infection between the two groups(P>0.05).The incidence rate of MACE in the observation group was notably lower in comparison with the control group(5.0%vs 18.3%,P<0.05).Conclusion rhBNP combined with dapagliflozin can improve the cardiac function and reduce the occurrence of MACE in the elderly AMI patients with left heart failure after interventional therapy,with good safety.