关键词:

急性心肌梗死, 心力衰竭, 诺欣妥, 达格列净, 心室重构

Abstract:

Objective To evaluate the effect of Dapagliflozin combined with Entresto on heart failure after emergency intervention in patients with acute myocardial infarction（AMI）. Methods A total of 120 patients with heart failure after an AMI who presented to the emergency department for percutaneous coronary intervention were enrolled and randomly assigned to the control or study groups. The control group was treated with standard therapy based on the addition of Entresto；In the study group，Dapagliflozin was added to the control group. At 6 months of treatment，NT ⁃ proBNP was measured by time ⁃ resolved immunofluorescence and Lp ⁃PLA2 was detected by upper transluminometry，and the patients end systolic left ventricular internal diameter，end diastolic left ventricular inter⁃ nal diameter，end diastolic left ventricular volume，ejection fraction，quality left ventricular index，remodeling index，and mace and adverse effects were recorded during the treatment follow⁃up period. Results After treatment， NT⁃proBNP and Lp⁃PLA2 levels were lower in both groups（P < 0.05），with the study group significantly lower than the control group（P < 0.05）. LVESD，LVEDD，LVEDV，LVMI and LVRI in the two groups were lower than those before treatment（P < 0.05），and LVEF was higher than those before treatment（P < 0.05）；LVESD，LVEDD， LVEDV，LVMI and LVRI in the study group were significantly lower than those in the control group（P < 0.05），and LVEF in the study group was significantly higher than those in the control group（P < 0.05）. At 3 and 6 months of treatment，the level of 6MWT in the two groups was significantly higher than that at 1 month of treatment（P < 0.05） and at 6 months of treatment，the level of 6MWT in the two groups was significantly higher than that at 3 months oftreatment（P < 0.05）. The degree of increase in the study group was significantly higher than that in the control group at the same time，with statistical difference（P < 0.05）. The incidence of mace in the study group was signifi⁃ cantly lower when compared to the control group（P < 0.05）；The incidence of adverse reactions was slightly higher， but there was no statistical significance（P < 0.05）. Conclusions In patients with heart failure after emergency PCI for AMI，the combination of Dapagliflozin and Entresto is superior to Entresto treatment in terms of lowering Lp⁃PLA2，improving cardiac function and left ventricular remodeling，lowering the incidence of mace，and having a good safety profile.

Key words:

acute myocardial infarction, heart failure, Entresto, Dapagliflozin, ventricular remodeling