Why the study?
Heart failure repeatedly exacerbates cardiac dysfunction and reduces activity capacity in the elderly, motivating an analysis of the mechanisms of action and outcomes of combined sacubitril-valsartan and SGLT2 inhibitor therapy.
Does combined therapy with sacubitril-valsartan and SGLT2 inhibitors improve cardiac function, neuroendocrine and inflammatory biomarkers, and clinical efficacy compared to sacubitril-valsartan alone in heart failure patients?
Cohort (n=150)
Blinded outcome assessment
No
Does combined therapy with sacubitril-valsartan and SGLT2 inhibitors improve cardiac function, neuroendocrine and inflammatory biomarkers, and clinical efficacy compared to sacubitril-valsartan alone in heart failure patients?
Absolute Event Rate: 93.33% vs 84%
p-value: p=<0.05
Adding SGLT2 inhibitors to sacubitril-valsartan in heart failure patients significantly improves cardiac function parameters, reduces neuroendocrine and inflammatory markers, enhances quality of life, and lowers complication and adverse event rates compared to sacubitril-valsartan alone.
Background Heart failure represents a challenging cardiovascular disorder among the elderly, repeatedly exacerbating cardiac dysfunction and a reduced capacity for activity, thereby presenting significant therapeutic challenge. Objective To analyse mechanisms of action and outcomes of combined therapy with sacubitril-valsartan and SGLT2 inhibitors for heart failure patients. Method From October 2023 to October 2025, 150 heart failure patients were recruited and categorized them to the SV group (sacubitril-valsartan) and the SS group (sacubitril-valsartan and SGLT2 inhibitor) according to their treatment regimens. Both groups of patients received treatment with sacubitril-valsartan; the SS group additionally received SGLT2 inhibitor supplementation. The main parameters pre- and post- treatment were assessed and analyzed among both groups, including changes in cardiac function related indicators [left ventricle ejection fraction (LVEF), left ventricle end-diastolic diameter (LVEDD), left ventricle end-systolic diameter (LVESD), and cardiac output (CO)], serum indicators [β-endorphin (β-EP), cardiotrophin-1 (CT-1), N-terminal pro-B-type natriuretic peptide (NT-proBNP) changes], inflammatory indicators (IL-1β), interleukin-6 (IL-6), tumor necrosis factors-α (TNF-α), and clinical efficacy. Secondary indicators include heart failure quality of life scale scores, complication incidences, and adverse events incidences. Result No marked discrepancy existed in the baseline clinical data among both groups ( P > 0.05). Post-treatment, the indicators in both groups demonstrated remarkable improvement ( P < 0.05). The LVEDD, LVESD, serum markers, inflammatory markers and MLHFQ scores in SS group were markedly below those in the SV group, whilst LVEF, CO and the overall clinical response rate were markedly increased ( P < 0.05). The complications and adverse reactions incidences were markedly reduced in SS group vs. SV group ( P < 0.05). Conclusion The combined use sacubitril-valsartan and SGLT2 inhibitors demonstrates efficacy in improving cardiac function indicators, downregulate neuroendocrine and inflammatory factor levels, enhance clinical efficacy in heart failure patients, and can serve as an important reference for comprehensive treatment of such patients.
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Xuzheng et al. (2026) conducted a cohort in Heart failure (n=150). Sacubitril-valsartan plus dapagliflozin (SGLT2 inhibitor) vs. Sacubitril-valsartan monotherapy was evaluated on Total clinical effective rate (composite of improvements in LVEF, LVEDD, LVESD, CO, serum markers, and inflammatory markers) (p=<0.05).
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