Dapagliflozin pada Gagal Jantung dengan Fraksi Ejeksi Rendah (HFrEF): Tinjauan Sistematis Mekanisme dan Efektivitas Klinis
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Latar Belakang: Gagal jantung dengan fraksi ejeksi rendah (HFrEF) merupakan kondisi serius dengan morbiditas dan mortalitas tinggi. Dapagliflozin menunjukkan efek kardioprotektif pada pasien HFrEF. Tujuan: Tinjauan ini mengeksplorasi mekanisme yang mendasari manfaat klinis dapagliflozin dan merangkum bukti terkini dari DAPA-HF serta sub-analisisnya mengenai efektivitasnya pada pasien dengan HFrEF. Metode: Literatur dicari secara sistematis di PubMed, Google Scholar, dan Scopus. Data dari studi yang memenuhi kriteria dianalisis secara naratif untuk merangkum mekanisme aksi dan outcome klinis. Hasil: Dapagliflozin meningkatkan efisiensi energi jantung, merangsang eritropoiesis, mengurangi fibrosis miokard, dan menurunkan stres oksidatif serta NT-proBNP. Secara klinis, terapi 10 mg/hari mengurangi rawat inap akibat gagal jantung dan kematian kardiovaskular dengan penurunan risiko relatif 26% (HR: 0.74), sementara pasien yang baru dirawat menunjukkan manfaat hingga 49% (HR: 0.51), konsisten di berbagai subpopulasi dan menambah keuntungan dari terapi standar. Kesimpulan: Dapagliflozin merupakan terapi tambahan efektif untuk HFrEF, memberikan manfaat cepat dan berkelanjutan, menurunkan morbiditas dan mortalitas, serta meningkatkan kualitas hidup pasien. Penelitian lebih lanjut diperlukan untuk memperluas penerapan klinis.
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Referensi
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