Comparative analysis of dapagliflozin and linagliptin in managing type 2 diabetes mellitus and heart failure: A retrospective study

This study retrospectively evaluates and compares the clinical effects of dapagliflozin and linagliptin on cardiac function and glycemic control in patients with type 2 diabetes mellitus (T2DM) complicated by heart failure (HF), thereby providing real-world evidence to support clinical decision-making. This retrospective study included 200 patients with both T2DM and HF, who were divided into 2 groups based on their treatment regimens: a control group and a treatment group (100 patients each). All patients received standard anti-HF therapy in combination with metformin. The control group was administered linagliptin (5 mg once daily before breakfast), while the treatment group received dapagliflozin (10 mg once daily) for a duration of 6 months. Relevant clinical data were collected and analyzed for both groups. Baseline characteristics were comparable between the 2 groups (P > .05). The total effective rate was significantly higher in the treatment group compared with the control group (97.5% vs 80.0%, P < .001), indicating a superior improvement in clinical symptoms with dapagliflozin. Both groups showed significant reductions in fasting blood glucose, 2-hour postprandial blood glucose, and HbA1c compared with baseline values (P < .001), with no statistically significant differences between groups (P > .05), suggesting that both drugs effectively improve glycemic control. The treatment group demonstrated greater improvements in NT-proBNP, fibroblast growth factor 23, central pulse pressure, left ventricular ejection fraction, left ventricular end-diastolic diameter, and left ventricular remodeling index compared with the control group (P < .05), indicating a more pronounced effect of dapagliflozin on cardiac function. The incidence of adverse drug reactions was low and not significantly different between groups (2.0% in the control group vs 4.0% in the treatment group, P > .05). Both dapagliflozin and linagliptin effectively improve glycemic control and cardiac function in patients with T2DM and HF, with favorable safety profiles. However, dapagliflozin appears to confer additional benefits in improving cardiac function, potentially due to its unique pharmacological mechanism.