Research Results in Pharmacology · Published 2025-12-29 · DOI 10.18413/rrpharmacology.11.816
Introduction: Optimal recovery of left ventricular ejection fraction (LVEF) in chronic heart failure (CHF) patients after acute myocardial infarction (AMI) is challenging in real-world settings, where therapy adherence varies. Aim: This study assessed the comparative effectiveness of revascularization, neurohumoral modulator (NHM) therapy, and sodium-glucose cotransporter-2 inhibitors (SGLT2i) on LVEF dynamics, considering actual adherence. Materials and Methods: A retrospective, population-based study used electronic medical records from the Electronic medical information and analytical system (2021–2023). 107 patients with AMI and CHF (NYHA I–III) receiving free outpatient care were included. Adherence was measured by Proportion of Days Covered (PDC). LVEF was evaluated at baseline, 6, and 12 months. Effect size was estimated using Hedges’ g. Results: Revascularization alone led to moderate LVEF improvement (+3.43% at 12 months, g=0.49). High NHM adherence (PDC ≥80%) was associated with greater LVEF gains (+6.70% vs. +3.43%, p=0.034). Only 24.3% maintained optimal adherence. Adding SGLT2i resulted in the largest improvement (+8.55% at 12 months, g=1.06), with 70% achieving LVEF ≥45%. Maximal SGLT2i effects were seen in patients with severe baseline impairment. Conclusions: Maximal myocardial recovery after AMI requires successful revascularization, high NHM adherence, and early SGLT2i initiation. Suboptimal adherence significantly reduces efficacy. These findings highlight the need for adherence-support programs and wider SGLT2i use to optimize outcomes in CHF patients.
Abstract from DOAJ. Public domain (CC0 1.0).
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