Sacubitril/valsartan plus dapagliflozin improves cardiac function and reduces MACE and rehospitalization in hFrEF: a retrospective study

OBJECTIVE: To evaluate the efficacy and safety of sacubitril/valsartan combined with dapagliflozin in heart failure with reduced ejection fraction (HFrEF). METHODS: A retrospective study included 400 HFrEF patients (control group: sacubitril valsartan, n=200; observation group: add dapagliflozin, n=200) treated for 6 months. Cardiac function, NT-proBNP, 6MWT, MACE, readmission rate, and adverse reactions were compared. RESULTS: After treatment, LVEF increased in both groups (control: 32.5 ± 5.6% to 38.6 ± 6.2%; observation: 32.8 ± 5.4% to 42.3 ± 6.5%, P<0.05), with greater improvement observed in observation group. LVEDD, LVESD, and NT-proBNP decreased, while 6MWT increased in both groups (all P<0.05), with superior changes in observation group. Readmission rate (8.5% vs. 16.0%, P=0.022) and MACE (6.0% vs. 9.5%, P=0.040) were significantly lower in observation group. No significant differences in adverse reactions between groups (all P>0.05). CONCLUSION: Sacubitril valsartan combined with dapagliflozin improves cardiac function, reduces NT-proBNP, enhances exercise tolerance, and lowers readmission and MACE rates without increasing adverse reactions, offering better clinical net benefit than sacubitril valsartan alone.