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May 16, 2026European Journal of Clinical Pharmacology0 citationsOpen Access

The Effect of the combination therapy of statin and dapagliflozin, a selective inhibitor of sodiumglucose Co-transporter type 2, in the treatment of Ischemic heart disease with heart failure: A randomized controlled trial

AAAsmaa M. AbdelkaderHOHasnaa OsamaEHEman S. Hassan

Key Result

Combination therapy with dapagliflozin and a statin maintained stable serum drug levels and significantly improved ejection fraction and lipid profiles in patients with ischemic heart disease.

Key Points

  • This study investigates the synergistic effects of dapagliflozin and statins on heart function and related parameters in ischemic heart disease patients.
  • Randomized controlled trial with 81 patients enrolled in three groups: SGLT2i group, Statin group, and Combination group.
  • Participants took treatments for three months prior to blood sampling, with assessments performed including ejection fraction via echocardiography and trough plasma concentrations measured by UPLC.
  • Data analysis conducted using SPSS v22, significance set at p < 0.05.
  • Combination group showed improved ejection fraction and lipid profiles with no adverse effects, maintaining stable drug levels (mean 7.3 ng/ml, SD 4.4 ng/ml, p=0.66).
  • Synergistic effects were indicated by additional metabolic benefits from SGLT2i.
  • Results suggest potential advantages of dapagliflozin-statins therapy in managing heart disease.

Study Design

Type

RCT (n=81)

Randomization

closed-envelope method

Multicenter

No

Structured PICO

Does combination therapy with dapagliflozin and statin improve ejection fraction and metabolic parameters compared to either alone in patients with ischemic heart disease?

P
Population
81 patients with ischemic heart disease at the department of cardiology, Fayoum University
I
Intervention
Combination therapy of Dapagliflozin (10 mg daily) and Statin (Atorvastatin 40 mg or Rosuvastatin 40 mg daily) for 3 months
C
Comparator
Dapagliflozin (10 mg daily) alone (n=26) or Statin (Atorvastatin 40 mg or Rosuvastatin 40 mg daily) alone (n=34)
O
Outcome
Trough plasma concentrations of Statins and SGLT2i, ejection fraction, and selected laboratory parameters (lipid profiles)surrogate

The combination of dapagliflozin and statins in patients with ischemic heart disease appears safe, does not negatively interact pharmacokinetically, and may provide synergistic benefits on ejection fraction and lipid profiles.

Main Result

Absolute Event Rate: 7.3% vs 7.8%

p-value: p=0.66

Limitations

  • relatively small sample size
  • single-center design
  • concomitant medications were not fully stratified or controlled
  • short duration of follow-up
  • small sample size (larger studies needed to confirm)

Abstract

Gliflozins (SGLT2 inhibitors) and statins are key treatments commonly used in patients with ischemic heart failure. Although both are well known for diminishing cardiovascular risk and heart failure–related mortality, the possible synergistic benefits of using them together have not been thoroughly investigated. This study aimed to correlate serum levels of Statins and SGLT2i in addition to estimate the ejection fraction and selected laboratory parameters to indicate the synergistic effect of their combination in ischemic heart disease patients. In this prospective, randomized, controlled trial, 81participating patients with ischemic heart disease at department of cardiology, Fayoum University, were randomly enrolled into three groups: SGLT2i group (GPI) (n = 26) who took Dapagliflozin (10 mg) daily, Statin group (GPII) (n = 34) who administrated Atorvastatin (40 mg) or Rosuvastatin (40 mg) daily and Combination group (GPIII) (n = 21) who took both Statin and Dapagliflozin. They had been on treatment for three months before blood sampling. The trough plasma concentrations of the included patients were assessed by ultra-performance liquid chromatography (UPLC). Ejection fraction was assessed by echocardiography, laboratory tests were performed, and data were analyzed with SPSS v22 (p < 0.05). Group: III showed no adverse effects, maintained stable drug levels as the mean was 7.3 ng/ml and SD was 4.4 ng/ml (p-value 0.66), demonstrated improved ejection fraction, lipid profiles and additional metabolic benefits from SGLT2i. Dapagliflozin–statin combination therapy appears potentially beneficial for heart disease patients without affecting drug levels, though larger studies are needed to confirm.

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Cite This Study

Abdelkader et al. (2026) conducted an RCT in Ischemic heart disease with heart failure (n=81). Dapagliflozin plus Statin (Atorvastatin or Rosuvastatin) vs. Dapagliflozin 10 mg alone or Statin alone was evaluated on Dapagliflozin serum concentration (ng/ml) (p=0.66). Combination therapy with dapagliflozin and a statin maintained stable serum drug levels and significantly improved ejection fraction and lipid profiles in patients with ischemic heart disease.

synapsesocial.com/papers/6a08093ca487c87a6a40b3eehttps://doi.org/10.1007/s00228-026-04050-6
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