Safety and Efficacy of Adding Dapagliflozin to Furosemide in Type 2 Diabetic Patients With Decompensated Heart Failure and Reduced Ejection Fraction

Frontiers in Cardiovascular Medicine

article

Ayman Ibrahim¹  Ramadan Ghaleb¹  Hossam Mansour¹  Amr Hanafy¹  Naggeh M. Mahmoud¹  Mohamed Abdelfatah Elsharef¹  Mohamed Kamal Salama¹  Saud M. Elsaughier¹  Lobna Abdel-Wahid²  Mona Embarek Mohamed³  Ahmed K. Ibrahim⁴  Ahmed Abdel-Galeel⁵ 

[1] Cardiology Department, Aswan University;Internal Medicine Department, Assiut University;Microbiology and Immunology Department, Faculty of Medicine, Assiut University;Community Medicine Department, Assiut University;Cardiovascular Medicine Department, Assiut University Heart Hospital, Assiut University

关键词: dapagliflozin;    furosemide;    diuretic;    heart failure;    diabetes mellitus;   

DOI  :  10.3389/fcvm.2020.602251

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background: Heart failure is the most common cause of hospitalization in elderly patients. It is likely that many of the mechanisms that contribute to reductions in systolic and diastolic function, seen in diabetic patients, place them at an increased risk of heart failure. Diuretic therapy, especially loop diuretics, is the usual way of managing congestion, particularly in volume-overloaded patients. Little is known about the beneficial effect of dapagliflozin when added to loop diuretics in managing patients with decompensated heart failure. Aim: To assess the effect of the addition of dapagliflozin to furosemide in managing decompensated patient with heart failure and reduced left ventricular ejection fraction in terms of weight loss and dyspnea improvement. Patients and Methods: The study included 100 type 2 diabetic patients who were admitted with decompensated heart failure. The study population was randomly divided into two arms. Serum electrolytes and kidney functions were followed up during their hospital stay. Results: With dapagliflozin, there was a statistically significant difference between the two groups regarding the change in body weight and body mass index. The diuresis parameters including urine output, total fluid loss, and fluid balance also showed a statistically significant difference in favor of the use of dapagliflozin, with no significant change in serum potassium or kidney functions. There was significant improvement in patient-reported dyspnea scores with the use of dapagliflozin. Conclusions: Dapagliflozin may provide a new drug option in the treatment of heart failure especially among vulnerable group of diabetics. It had no remarkable effects on serum potassium level and kidney functions. Clinical Trial Registration:www.ClinicalTrials.gov , identifier: {"type":"clinical-trial","attrs":{"text":"NCT04385589","term_id":"NCT04385589"}} NCT04385589 .

【 授权许可】

CC BY