The Effects of Empagliflozin Combined with Entresto Therapy on Serum hs-CRP,NT-proBNP and Prognosis in Patients with Heart Failure after Acute Myocardial Infarction
SHI Lin
WANG Chunmei
QI Yu
ZHANG Yanping
CHENG Fangbing
WANG Wen
Abstract：Objective To investigate the effects of empagliflozin combined with Entresto(Sacubitril/Valsartan)therapy on serum high-sensitivity C-reactive protein(hs-CRP),N-terminal pro-B-type natriuretic peptide(NT-proBNP),and prognosis in patients with heart failure after acute myocardial infarction(AMI).Methods A total of 178 patients with heart failure after AMI admitted to Qinhuangdao Hospital of Peking University Third Hospital from August 2022 to June 2024 were selected.They were randomly divided into a control group(89 cases)and an experimental group(89 cases)using a random number table method.Patients in the control group received treatment with Entresto,and patients in the experimental group received empagliflozin in addition to the control group's regimen.Cardiac function indicators(left ventricular ejection fraction,left ventricular end-systolic volume,left ventricular end-diastolic volume),serum inflammatory markers(hs-CRP,B-type natriuretic peptide,NT-proBNP)levels,heart rate,6-minute walk test distance,prognostic biomarkers(matrix metalloproteinase-9,myeloperoxidase)levels,post-treatment blood pressure,and incidence of adverse reactions were compared between the two groups before and after 3 months of treatment.Multivariate Cox proportional hazards regression analysis was used to identify factors influencing patient prognosis[including major adverse cardiovascular events(MACE),readmission rate,and all-cause mortality rate].Results After 3 months of treatment,left ventricular ejection fraction and 6-minute walk test distance in the experimental group were higher/longer than those in the control group,while left ventricular end-systolic volume,left ventricular end-diastolic volume,hs-CRP,B-type natriuretic peptide,NT-proBNP,heart rate,matrix metalloproteinase-9,and myeloperoxidase levels were lower,with statistically significant differences(P<0.05).There was no statistically significant difference in blood pressure or adverse reaction incidence between the two groups after treatment(P>0.05).The 6-month follow-up results showed that the incidence of MACE,readmission rate,and all-cause mortality rate in the experimental group were significantly lower than those in the control group(21.35%vs 35.96%,P<0.05;10.11%vs 24.72%,P<0.05;2.25%vs 10.11%,P<0.05).Multivariate Cox proportional hazards regression analysis showed that treatment modality was an independent factor affecting patient prognosis:compared with the control group,the experimental group had a 46.7%reduced risk of MACE(HR=0.533,95%CI:0.312-0.921,P<0.05),a 58.6%reduced risk of readmission(HR=0.414,95%CI:0.210-0.803,P<0.05),and an 80.7%reduced risk of all-cause mortality(HR=0.193,95%CI:0.042-0.881,P<0.05).Conclusion Adding empagliflozin to Entresto therapy for heart failure after AMI can significantly improve cardiac function,reduce inflammatory response,and increase exercise tolerance.Furthermore,the combination therapy reduces the risk of MACE,readmission rates,and all-cause mortality,without increasing blood pressure fluctuations or adverse reactions,demonstrating good safety.
Keywords：empagliflozinEntrestoacute myocardial infarctionheart failure
Publication Date：2025-08-20
Online Publishing Date：2025-09-18(First online date of this platform, not the publication date of the document)
Pages：6( 145-150 )