Терапия №1 (приложение) / 2026
EXPLORATION OF THE COMBINATION USE OF QILIQIANGXIN AND SGLT2 INHIBITOR: REAL-WORLD ANALYSES FROM THE CHINA HEART FAILURE CENTER
State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
Objective: Despite advancements in guideline-directed medical therapy, particularly the integration of sodium-glucose cotransporter 2 inhibitors (SGLT2i), patients with heart failure with reduced ejection fraction (HFrEF) experience substantial residual cardiovascular risk. The real-world clinical effectiveness of adjunctive treatments, specifically adding the traditional Chinese medicine Qiliqiangxin (QLQX) to contemporary SGLT2i-based regimens remains unestablished.
Methods: This nationwide multicenter observational cohort study leveraged data from the China Cardiovascular Association Database-Heart Failure Center Registry between January 2017 and March 2025. 14,367 eligible participants were adults with an established diagnosis of HFrEF (left ventricular ejection fraction < 40%). Patients were stratified into three regimens: combination therapy (QLQX plus SGLT2i), QLQX monotherapy, and SGLT2i monotherapy. The primary endpoint was a composite of cardiovascular death or first hospitalization for heart failure (HHF) evaluated over a 540-day follow-up. Propensity score matching (1:1:2 ratio) was utilized to balance baseline covariates.
Results: The propensity-matched cohort included 3540 patients (885 receiving combination therapy, 885 receiving QLQX monotherapy, and 1770 receiving SGLT2i monotherapy). Compared with SGLT2i monotherapy, combination therapy was associated with a significantly lower risk of the primary composite outcome (hazard ratio [HR], 0.814; 95% CI, 0.680 to 0.974; P=0.02). This reduction was primarily driven by a decreased incidence of HHF (HR, 0.783; 95% CI, 0.634 to 0.966; P=0.02). No significant difference was observed in the comparison between the combination and SGLT2i groups (HR, 0.909; 95% CI, 0.641 to 1.289; P=0.59). Furthermore, QLQX monotherapy did not demonstrate a significant difference in the primary ou...
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