Empagliflozin and Dapagliflozin in Improving Ejection Fraction: A Prospective Observational Comparison of Clinical Outcomes and Patient Reported Quality of Life

Background SGLT2 inhibitors have transformed heart failure treatment, especially empagliflozin and dapagliflozin. Although both have proven cardiovascular benefits in clinical trials, there is little data comparing them in real-world settings. This study aims to address that by comparing their effects on heart function, lab tests, echocardiography, and quality of life using routine clinical data and the Kansas City Cardiomyopathy Questionnaire-12. Methods We conducted a prospective observational study with 70 heart failure patients, evenly divided between those taking empagliflozin 10 mg daily and those on dapagliflozin 10 mg daily as part of their usual care. We collected vital signs, blood tests, echocardiographic measures, including left ventricular ejection fraction, and KCCQ-12 scores. Statistical analysis included t-tests, Mann-Whitney U, Chi-square, ANOVA, Shapiro-Wilk for normality, Levene’s test for equal variances, and Pearson correlation. Results with p-values under 0.005 were considered significant. Results The groups were similar in age, gender, rates of hypertension, HbA1c, and lipid levels. However, more patients in the dapagliflozin group had diabetes (68.6% vs. 31.4%, p = 0.007). Both drugs significantly lowered systolic blood pressure and improved ejection fraction. Dapagliflozin caused a larger drop in sodium levels (2.51 vs 0.83 mEq/L, p = 0.007). Among diabetic patients, empagliflozin reduced blood glucose by a greater amount (-75.00 vs -42.33 mg/dL). Patients on empagliflozin also had higher overall KCCQ-12 scores (66.22 vs. 56.06), with a significant difference in symptom frequency (p = 0.033). Improvements in ejection fraction, kidney function, hemoglobin, and lipids were similar for both drugs. Conclusions Empagliflozin and dapagliflozin showed similar effects in heart failure patients, though some important differences emerged. Empagliflozin was associated with greater reductions in KCCQ-12 symptom frequency scores and blood sugar levels in patients with diabetes, whereas dapagliflozin was associated with a larger drop in serum sodium levels. These results suggest that although both drugs are generally equivalent, individual differences might guide personalized treatment choices.