Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction: a randomized controlled trial

ObjectiveTo explore the efficacy and safety of dapagliflozin in patients with paroxysmal atrial fibrillation (PAF) combined with heart failure with preserved ejection fraction (HFpEF). MethodsA total of 120 patients with PAF combined with HFpEF treated at Jinshan Hospital of Fudan University from Ju...

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Main Authors: Xiaoyu LIAN, Fei PENG, Hui GONG, Juying QIAN
Format: Article
Language:English
Published: Shanghai Chinese Clinical Medicine Press Co., Ltd. 2025-06-01
Series:Zhongguo Linchuang Yixue
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Online Access:https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250497
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author Xiaoyu LIAN
Fei PENG
Hui GONG
Juying QIAN
author_facet Xiaoyu LIAN
Fei PENG
Hui GONG
Juying QIAN
author_sort Xiaoyu LIAN
collection DOAJ
description ObjectiveTo explore the efficacy and safety of dapagliflozin in patients with paroxysmal atrial fibrillation (PAF) combined with heart failure with preserved ejection fraction (HFpEF). MethodsA total of 120 patients with PAF combined with HFpEF treated at Jinshan Hospital of Fudan University from July 2022 to July 2023 were selected and randomly divided into the dapagliflozin group (n=60, standard treatment combined with dapagliflozin) and the control group (n=60, standard treatment combined with placebo). After 12 months of follow-up, the Kansas City Cardiomyopathy Questionnaire-Total Symptom Score (KCCQ-TSS), PAF duration, recurrence rate and frequency of PAF, left atrial diameter, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction, P-wave dispersion, blood pressure, plasma N-terminal pro-brain natriuretic peptide (NT-proBNP), estimated glomerular filtration rate (eGFR), and glycated hemoglobin A1C (HbA1C) were compared between the two groups. Cardiovascular outcomes and adverse events were observed. ResultsA total of 10 patients lost to follow-up, and 110 patients were included in the analysis (55 in each group). After 12 months of treatment, the KCCQ-TSS in the dapagliflozin group was significantly higher than that in the control group ([61.68±2.65] points vs [44.98±4.76] points, P<0.001). The PAF duration in the dapagliflozin group was significantly shorter than that in the control group ([144±18] min vs [270±24] min, P=0.045). After treatment, frequency of PAF, NT-proBNP levels, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left atrial diameter, P-wave dispersion, and HbA1C levels showed statistical differences between the two groups (P<0.05). The heart failure readmission rate and PAF recurrence rate in the dapagliflozin group were significantly lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups during treatment. ConclusionsDapagliflozin improves patients’ quality of life, reduces PAF duration and recurrence rate, decreases heart failure readmission rate, lowers NT-proBNP levels, reverses cardiac remodeling, and demonstrates favorable safety in patients with PAF combined with HFpEF.
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spelling doaj-art-39edb005d68440a283499bc3e9dd01202025-08-20T02:36:15ZengShanghai Chinese Clinical Medicine Press Co., Ltd.Zhongguo Linchuang Yixue1008-63582025-06-0132334234910.12025/j.issn.1008-6358.2025.2025049720250497Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction: a randomized controlled trialXiaoyu LIAN0Fei PENG1Hui GONG2Juying QIAN3Department of Cardiology, Jinshan Hospital of Fudan University, Shanghai 201508, ChinaDepartment of Cardiology, Jinshan Hospital of Fudan University, Shanghai 201508, ChinaDepartment of Cardiology, Jinshan Hospital of Fudan University, Shanghai 201508, ChinaDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Health Commission Key Laboratory of Ischemic Heart Diseases, Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, National Clinical Research Center for Interventional Medicine, Shanghai 200032, ChinaObjectiveTo explore the efficacy and safety of dapagliflozin in patients with paroxysmal atrial fibrillation (PAF) combined with heart failure with preserved ejection fraction (HFpEF). MethodsA total of 120 patients with PAF combined with HFpEF treated at Jinshan Hospital of Fudan University from July 2022 to July 2023 were selected and randomly divided into the dapagliflozin group (n=60, standard treatment combined with dapagliflozin) and the control group (n=60, standard treatment combined with placebo). After 12 months of follow-up, the Kansas City Cardiomyopathy Questionnaire-Total Symptom Score (KCCQ-TSS), PAF duration, recurrence rate and frequency of PAF, left atrial diameter, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction, P-wave dispersion, blood pressure, plasma N-terminal pro-brain natriuretic peptide (NT-proBNP), estimated glomerular filtration rate (eGFR), and glycated hemoglobin A1C (HbA1C) were compared between the two groups. Cardiovascular outcomes and adverse events were observed. ResultsA total of 10 patients lost to follow-up, and 110 patients were included in the analysis (55 in each group). After 12 months of treatment, the KCCQ-TSS in the dapagliflozin group was significantly higher than that in the control group ([61.68±2.65] points vs [44.98±4.76] points, P<0.001). The PAF duration in the dapagliflozin group was significantly shorter than that in the control group ([144±18] min vs [270±24] min, P=0.045). After treatment, frequency of PAF, NT-proBNP levels, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left atrial diameter, P-wave dispersion, and HbA1C levels showed statistical differences between the two groups (P<0.05). The heart failure readmission rate and PAF recurrence rate in the dapagliflozin group were significantly lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups during treatment. ConclusionsDapagliflozin improves patients’ quality of life, reduces PAF duration and recurrence rate, decreases heart failure readmission rate, lowers NT-proBNP levels, reverses cardiac remodeling, and demonstrates favorable safety in patients with PAF combined with HFpEF.https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250497dapagliflozinheart failure with preserved ejection fractionparoxysmal atrial fibrillationkansas city cardiomyopathy questionnaire-total symptom score
spellingShingle Xiaoyu LIAN
Fei PENG
Hui GONG
Juying QIAN
Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction: a randomized controlled trial
Zhongguo Linchuang Yixue
dapagliflozin
heart failure with preserved ejection fraction
paroxysmal atrial fibrillation
kansas city cardiomyopathy questionnaire-total symptom score
title Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction: a randomized controlled trial
title_full Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction: a randomized controlled trial
title_fullStr Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction: a randomized controlled trial
title_full_unstemmed Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction: a randomized controlled trial
title_short Effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction: a randomized controlled trial
title_sort effect of dapagliflozin in paroxysmal atrial fibrillation combined with heart failure with preserved ejection fraction a randomized controlled trial
topic dapagliflozin
heart failure with preserved ejection fraction
paroxysmal atrial fibrillation
kansas city cardiomyopathy questionnaire-total symptom score
url https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250497
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