A Multicenter, Randomized, Double-Blind, Exploratory Clinical Trial to Evaluate the Efficacy and Safety in Concomitant Administration of Macitentan and Dapagliflozin in Patients With Heart Failure With Mildly Reduced and Preserved Ejection Fraction (HFmrEF and HFpEF) and Combined Pre- and Post-capillary Pulmonary Hypertension (CpcPH)
This clinical trial will evaluate whether combination therapy with Dapagliflozin + Macitentan improves outcomes compared to Dapagliflozin + placebo in patients with combined pre- and post-capillary pulmonary hypertension (CpcPH). The study will measure changes in pulmonary vascular resistance, NT-proBNP, 6-minute walk distance, and quality of life (KCCQ scores) over 24 weeks. Participants will be randomly assigned to one of two groups, take study medication for 24 weeks, and undergo regular clinical, laboratory, and safety assessments.
∙ \<Screening Visit (Visit 1)\>
• A male or female adults aged 19 years or older in South Korea
• LVEF greater than 40% on echocardiogram performed within 12 weeks prior to screening
• Presence of heart failure with mildly reduced ejection fraction (HFmrEF) or preserved ejection fraction (HFpEF) accompanied by combined pre- and post-capillary pulmonary hypertension (CpcPH)
• Meeting all of the following criteria on RHC performed within 48 weeks prior to screening:
‣ mPAP \> 20 mmHg
⁃ PVR \> 2 Wood units (WU)
⁃ PAWP \> 15 mmHg
• World Health Organization Functional Class (WHO-FC) II or III at the time of screening
• If taking any of the following medications at the time of screening, the participant must have been on a stable dose for at least 3 months:
‣ Renin-angiotensin system inhibitors
⁃ Beta-blockers
⁃ Mineralocorticoid receptor antagonists (aldosterone antagonists)
⁃ Sodium-glucose cotransporter-2 (SGLT2) inhibitors
⁃ Ivabradine
∙ \<Baseline Visit (Visit 2)\>
∙ 1\. World Health Organization Functional Class (WHO-FC) II or III at the time of baseline visit