Key result
Adding dapagliflozin to sacubitril/valsartan is linked to an absolute ~8% reduction in 6-month readmissions.
Why the study?
The efficacy and safety of sacubitril/valsartan combined with dapagliflozin in HFrEF patients required evaluation.
Does adding dapagliflozin to sacubitril/valsartan improve cardiac function and reduce MACE and readmission in patients with HFrEF?
Cohort (n=400)
Does adding dapagliflozin to sacubitril/valsartan improve cardiac function and reduce MACE and readmission in patients with HFrEF?
Absolute Event Rate: 8.5% vs 16%
p-value: p=0.022
The addition of dapagliflozin to sacubitril/valsartan in HFrEF patients significantly improves cardiac function, exercise tolerance, and reduces MACE and readmissions without increasing adverse events.
May support combination therapy in HFrEF; hypothesis-generating and requires randomized confirmation before practice change.
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.
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Lu et al. (2026) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=400). Sacubitril/valsartan plus dapagliflozin vs. Sacubitril/valsartan alone was evaluated on Readmission rate (p=0.022). Sacubitril/valsartan combined with dapagliflozin significantly reduced the 6-month readmission rate (8.5% vs. 16.0%, P=0.022) and MACE (6.0% vs. 9.5%, P=0.040) compared to sacubitril/valsartan alone.
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