Cai Ru-Ping, Xu Yu-Li, Su Qiang
Department of Cardiology, Affiliated Hospital of Guilin Medical University, Guilin, China.
Cardiol Res Pract. 2021 Mar 30;2021:6657380. doi: 10.1155/2021/6657380. eCollection 2021.
Sodium-glucose cotransporter-2 (SGLT2) inhibitors represent newly developed oral antidiabetic drugs that are practiced for type 2 diabetes mellitus management and may decrease the risk of the first hospitalization in heart failure. The activity of SGLT2 inhibitors is not related to glucose, and the effectiveness and safety of SGLT2 inhibitors in individuals with chronic heart failure (CHF) remain unclear. We systematically retrieved PubMed, Cochrane Library, Embase, NCKI, VIP, Wanfang Data, and ClinicalTrials.gov records to identify eligible trials. The primary endpoints were cardiovascular death/hospitalization for heart failure (CV death/HHF), cardiovascular death, and hospitalization for heart failure. Secondary endpoints included hypoglycemia, volume depletion, urinary tract infection, left ventricular ejection fraction (LVEF), and NT-proBNP. Nine randomized controlled clinical trials were included. Dapagliflozin was reported to significantly decrease CV death/HHF (relative risk (RR): 0.75; 95% confidence interval (CI): 0.68-0.84), CV death (RR: 0.80; 95% CI: 0.68-0.93), and HHF (RR: 0.72; 95% CI: 0.63-0.83). There was no effect on hypoglycemia (RR: 0.69; 95% CI: 0.34-1.40), volume depletion (RR: 1.17; 95% CI: 0.97-1.41), urinary tract infection (RR: 0.82; 95% CI: 0.43-1.57), LVEF (WMD: 0.53; 95% CI: -4.04-5.09), or NT-proBNP (SMD: -0.66; 95% CI: -1.42-0.10). The risk of CV death/HHF, CV death, and HHF was lower among patients receiving dapagliflozin than patients receiving placebo.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂是新开发的口服抗糖尿病药物，用于治疗2型糖尿病，可能会降低首次因心力衰竭住院的风险。SGLT2抑制剂的活性与血糖无关，其在慢性心力衰竭（CHF）患者中的有效性和安全性仍不明确。我们系统检索了PubMed、Cochrane图书馆、Embase、中国知网、维普资讯、万方数据和ClinicalTrials.gov记录，以识别符合条件的试验。主要终点为心血管死亡/因心力衰竭住院（CV死亡/HHF）、心血管死亡和因心力衰竭住院。次要终点包括低血糖、容量耗竭、尿路感染、左心室射血分数（LVEF）和N末端B型利钠肽原（NT-proBNP）。纳入了9项随机对照临床试验。据报道，达格列净可显著降低CV死亡/HHF（风险比（RR）：0.75；95%置信区间（CI）：0.68-0.84）、CV死亡（RR：0.80；95%CI：0.68-0.93）和HHF（RR：0.72；95%CI：0.63-0.83）。对低血糖（RR：0.69；95%CI：0.34-1.40）、容量耗竭（RR：1.17；95%CI：0.97-1.41）、尿路感染（RR：0.82；95%CI：0.43-1.57）、LVEF（加权均数差（WMD）：0.53；95%CI：-4.04-5.09）或NT-proBNP（标准化均数差（SMD）：-0.66；95%CI：-1.42-0.10）无影响。接受达格列净治疗的患者发生CV死亡/HHF、CV死亡和HHF的风险低于接受安慰剂治疗的患者。
