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To observe the clinical efficacy and safety of vericiguat tablets combined with sacubitril valsartan sodium (Sac/Val) tablets in the treatment of patients with heart failure with reduced ejection fraction (HFrEF).
The HFrEF patients were divided into control group and treatment group according to the cohort method. The control group was treated with Sac/Val tablets 200 mg per time, bid, orally. On the basis of control group, the treatment group was treated with vericiguat tablets 2.5 mg per time, qd, taken with meal. Two groups were treated for 3 months. The clinical efficacy, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and end-systolic diameter (LVESD), levels of high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), nitric oxide (NO), N-terminal pro-brain natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN) and serum creatinine (SCr), and safety were compared between the two groups. During follow-up, the heart failure rehospitalization rates and major adverse cardiovascular events were compared between the two groups.
Treatment group was enrolled 53 patients, control group was enrolled 53 patients. After treatment, the total effective rates of treatment and control groups were 94.34% (50 cases / 53 cases) and 81.13% (43 cases / 53 cases) with statistical significant difference (P<0.05). After treatment, the LVEF of treatment and control groups were (48.02±5.20)% and (43.02±4.33)%, the LVEDDs were (52.85±6.30) and (55.63±6.88) mm, the LVESDs were (41.64±6.40) and (44.22±5.85) mm, the levels of hs-CRP were (10.22±2.63) and (14.60±2.98) mg·L-1, the levels of IL-6 were (14.48±2.40) and (17.36±2.52) pg·mL-1, the levels of NO were (102.60±20.16) and (92.16±16.33) μmol·L-1, the levels of NT-proBNP were (898.74±102.20) and (1315.60±182.64) ng·L-1, the levels of BUN were (12.02±2.28) and (13.45±2.33) mmol·L-1, the levels of SCr were (82.22±5.89) and (85.64±6.03) μmol·L-1, the heart failure rehospitalization rates were 5.66% and 13.21%, respectively; the differences were statistical significant between two groups (all P<0.05). The adverse drug reactions of treatment group were hyperkalemia, hypotension, renal dysfunction, dizziness and headache, while those in control group were renal dysfunction, hyperkalemia, and hypotension. The major adverse cardiovascular events of treatment group were angina pectoris and acute myocardial infarction, while those in control group were angina pectoris, acute myocardial infarction and atrial fibrillation. The incidences of total adverse drug reactions in treatment and control groups were 13.21% and 7.55%, the incidences of major adverse cardiovascular events were 5.66% and 13.21%, respectively, without statistically significant differences (all P>0.05).
Vericiguat tablets combined with Sac/Val tablets have a definitive clinical efficacy in the treatment of HFrEF patients, which can improve cardiac and endothelial function, reduce inflammatory response and readmission times, without increasing the incidences of adverse drug reactions.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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