Sodium‐glucose cotransporter‐2 inhibitors in heart failure: an updated meta‐analysis
Abstract Aims We aimed to examine efficacy and safety outcomes of sodium‐glucose cotransporter‐2 inhibitor (SGLT2i) for the treatment of heart failure (HF), especially in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results PubMed, Web of Science, and Cochrane Li...
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Wiley
2022-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.13905 |
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| author | Yang Cao Pengxiao Li Yi Li Yaling Han |
| author_facet | Yang Cao Pengxiao Li Yi Li Yaling Han |
| author_sort | Yang Cao |
| collection | DOAJ |
| description | Abstract Aims We aimed to examine efficacy and safety outcomes of sodium‐glucose cotransporter‐2 inhibitor (SGLT2i) for the treatment of heart failure (HF), especially in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results PubMed, Web of Science, and Cochrane Library were searched to identify randomized controlled trials comparing SGLT2i vs. placebo in HF patients. A total of 10 studies with 23 852 HF patients were eventually included. Compared with placebo, SGLT2i is associated with a lower incidence of composite of first hospitalization for heart failure (HHF) or cardiovascular death (CV death) [hazard ratio (HR) = 0.76 95% confidence interval (CI) = 0.71–0.81], which is consistent regardless of the diabetes status, type of gliflozines used, and follow‐up duration. SGLT2i can reduce the risk of total HHF or CV death (HR = 0.74, 95%CI = 0.68–0.81), first HHF (HR = 0.69, 95%CI = 0.64–0.75), CV death (HR = 0.88, 95%CI = 0.80–0.96), any death (HR = 0.90, 95%CI = 0.83–0.97), and any serious events (HR = 0.90, 95%CI = 0.87–0.93) in HF patients, at the cost of increased risk of urinary tract infections (risk ratio = 1.17, 95%CI = 1.03–1.33). In HFpEF patients, SGLT2i is associated with a significant reduction of composite of first HHF or CV death (HR = 0.81, 95%CI = 0.73–0.91), first HHF (HR = 0.71, 95%CI = 0.62–0.82), and total HHF or CV death (HR = 0.61, 95%CI = 0.43–0.86). Conclusions Sodium‐glucose cotransporter‐2 inhibitor contributed to better efficacy outcomes in overall HF patients and showed an inspiring breakthrough in the treatment of HFpEF. |
| format | Article |
| id | doaj-art-3c874530ef5444ac8b22dd8dffa6f7e6 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-3c874530ef5444ac8b22dd8dffa6f7e62025-02-05T05:22:10ZengWileyESC Heart Failure2055-58222022-06-01931942195310.1002/ehf2.13905Sodium‐glucose cotransporter‐2 inhibitors in heart failure: an updated meta‐analysisYang Cao0Pengxiao Li1Yi Li2Yaling Han3The Department of Cardiology, Xijing Hospital Air Force Medical University Xi'an ChinaThe Department of Cardiology, Xijing Hospital Air Force Medical University Xi'an ChinaThe Department of Cardiology General Hospital of Northern Theater Command 83 Wenhua Road Shenyang 110016 ChinaThe Department of Cardiology General Hospital of Northern Theater Command 83 Wenhua Road Shenyang 110016 ChinaAbstract Aims We aimed to examine efficacy and safety outcomes of sodium‐glucose cotransporter‐2 inhibitor (SGLT2i) for the treatment of heart failure (HF), especially in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results PubMed, Web of Science, and Cochrane Library were searched to identify randomized controlled trials comparing SGLT2i vs. placebo in HF patients. A total of 10 studies with 23 852 HF patients were eventually included. Compared with placebo, SGLT2i is associated with a lower incidence of composite of first hospitalization for heart failure (HHF) or cardiovascular death (CV death) [hazard ratio (HR) = 0.76 95% confidence interval (CI) = 0.71–0.81], which is consistent regardless of the diabetes status, type of gliflozines used, and follow‐up duration. SGLT2i can reduce the risk of total HHF or CV death (HR = 0.74, 95%CI = 0.68–0.81), first HHF (HR = 0.69, 95%CI = 0.64–0.75), CV death (HR = 0.88, 95%CI = 0.80–0.96), any death (HR = 0.90, 95%CI = 0.83–0.97), and any serious events (HR = 0.90, 95%CI = 0.87–0.93) in HF patients, at the cost of increased risk of urinary tract infections (risk ratio = 1.17, 95%CI = 1.03–1.33). In HFpEF patients, SGLT2i is associated with a significant reduction of composite of first HHF or CV death (HR = 0.81, 95%CI = 0.73–0.91), first HHF (HR = 0.71, 95%CI = 0.62–0.82), and total HHF or CV death (HR = 0.61, 95%CI = 0.43–0.86). Conclusions Sodium‐glucose cotransporter‐2 inhibitor contributed to better efficacy outcomes in overall HF patients and showed an inspiring breakthrough in the treatment of HFpEF.https://doi.org/10.1002/ehf2.13905Heart failureSodium‐glucose cotransporter‐2 inhibitorsHeart failure with preserved ejection fractionMeta‐analysis |
| spellingShingle | Yang Cao Pengxiao Li Yi Li Yaling Han Sodium‐glucose cotransporter‐2 inhibitors in heart failure: an updated meta‐analysis ESC Heart Failure Heart failure Sodium‐glucose cotransporter‐2 inhibitors Heart failure with preserved ejection fraction Meta‐analysis |
| title | Sodium‐glucose cotransporter‐2 inhibitors in heart failure: an updated meta‐analysis |
| title_full | Sodium‐glucose cotransporter‐2 inhibitors in heart failure: an updated meta‐analysis |
| title_fullStr | Sodium‐glucose cotransporter‐2 inhibitors in heart failure: an updated meta‐analysis |
| title_full_unstemmed | Sodium‐glucose cotransporter‐2 inhibitors in heart failure: an updated meta‐analysis |
| title_short | Sodium‐glucose cotransporter‐2 inhibitors in heart failure: an updated meta‐analysis |
| title_sort | sodium glucose cotransporter 2 inhibitors in heart failure an updated meta analysis |
| topic | Heart failure Sodium‐glucose cotransporter‐2 inhibitors Heart failure with preserved ejection fraction Meta‐analysis |
| url | https://doi.org/10.1002/ehf2.13905 |
| work_keys_str_mv | AT yangcao sodiumglucosecotransporter2inhibitorsinheartfailureanupdatedmetaanalysis AT pengxiaoli sodiumglucosecotransporter2inhibitorsinheartfailureanupdatedmetaanalysis AT yili sodiumglucosecotransporter2inhibitorsinheartfailureanupdatedmetaanalysis AT yalinghan sodiumglucosecotransporter2inhibitorsinheartfailureanupdatedmetaanalysis |