Pan Deng, Xu Lin, Chen Pengfei, Jiang Huiping, Shi Dazhuo, Guo Ming
Graduate School of Beijing University of Traditional Chinese Medicine, Beijing, China.
National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Front Cardiovasc Med. 2021 Jun 22;8:683281. doi: 10.3389/fcvm.2021.683281. eCollection 2021.
The purpose of the study is to evaluate the effect of empagliflozin in patients with heart failure (HF). We performed a systematic search of PubMed, EMBASE, and the Cochrane Library database through January 20, 2021. Randomized controlled trials (RCTs) were included that compared empagliflozin and placebo in patients with HF. Dichotomous variables were expressed as risk ratios (RRs) with 95% confidence intervals (CIs). Continuous variables were calculated and expressed as mean differences (MD) and standard deviation (SD). Meta-analysis was conducted using a random-effects model on outcomes with high heterogeneity. Seven studies were included in our meta-analysis ( = 5,150). Significant differences were observed in a composite of cardiovascular death or hospitalization for worsening heart failure [RR: 0.77 (95% CI 0.68-0.87); = 18%; < 0.0001), hospitalization for worsening heart failure [RR: 0.71 (95% CI 0.61-0.82); = 0%; < 0.00001], changes in Kansas City Cardiomyopathy Questionnaire (KCCQ) score [MD: 1.70 (95% CI 1.67-1.73); = 0%; < 0.00001], and changes in body weight [MD: -1.43 (95% CI -2.15 to -0.72); = 84%; < 0.0001) from baseline. However, empagliflozin did not show a better change in the 6-min walk test (6MWT) [MD: 34.06 (95% CI -29.75-97.88); = 97%; = 0.30] or NT-proBNP [MD: -98.36 (95% CI, -225.83-29.11); = 68%; = 0.13] from baseline. The findings suggest that empagliflozin was effective in reducing a composite of cardiovascular death or hospitalization for worsening heart failure. Further well-designed RCTs are needed to evaluate the long-term effect of empagliflozin in patients with HF. CRD42021231712.
本研究的目的是评估恩格列净对心力衰竭（HF）患者的疗效。我们对截至2021年1月20日的PubMed、EMBASE和Cochrane图书馆数据库进行了系统检索。纳入了比较恩格列净与安慰剂治疗HF患者的随机对照试验（RCT）。二分变量以风险比（RRs）和95%置信区间（CIs）表示。连续变量经计算后以平均差（MD）和标准差（SD）表示。对具有高度异质性的结局采用随机效应模型进行荟萃分析。我们的荟萃分析纳入了7项研究（n = 5150）。在心血管死亡或因心力衰竭恶化住院的复合终点方面观察到显著差异[RR：0.77（95%CI 0.68 - 0.87）；I² = 18%；P < 0.0001]，因心力衰竭恶化住院方面[RR：0.71（95%CI 0.61 - 0.82）；I² = 0%；P < 0.00001]，堪萨斯城心肌病问卷（KCCQ）评分变化[MD：1.70（95%CI 1.67 - 1.73）；I² = 0%；P < 0.00001]，以及与基线相比体重变化[MD： - 1.43（95%CI - 2.15至 - 0.72）；I² = 84%；P < 0.0001]。然而，恩格列净在6分钟步行试验（6MWT）[MD：34.06（95%CI - 29.75 - 97.88）；I² = 97%；P = 0.30]或N末端脑钠肽前体（NT - proBNP）[MD： - 98.36（95%CI, - 225.83 - 29.11）；I² = 68%；P = 0.13]方面与基线相比未显示出更好的变化。研究结果表明，恩格列净在降低心血管死亡或因心力衰竭恶化住院的复合终点方面有效。需要进一步设计良好的RCT来评估恩格列净对HF患者的长期疗效。CRD42021231712。
