Tsampasian Vasiliki, Baral Ranu, Chattopadhyay Rahul, Debski Maciej, Joshi Shruti S, Reinhold Johannes, Dweck Marc R, Garg Pankaj, Vassiliou Vassilios S
Department of Cardiology, Norfolk and Norwich University Hospitals, Norwich, UK.
Department of Cardiology, Cambridge University Hospitals, Cambridge, UK.
Cardiol Res Pract. 2021 Aug 19;2021:9927533. doi: 10.1155/2021/9927533. eCollection 2021.
Recent randomised controlled trials (RCTs) have shown a significant prognostic benefit of sodium-glucose cotransporter 2 (SGLT2) inhibitors in the cardiovascular (CV) profile of patients with diabetes. This systematic review and meta-analysis aim to provide a concise evaluation of all the available evidence for the use of these agents in patients with heart failure (HF) regardless of their baseline diabetes status.
PubMed, Web of Science, and Cochrane library databases were systematically searched from inception until November 20 2020. Eight studies consisting of 13,275 patients were included in the meta-analysis. For the total population, SGLT2 inhibitors reduced the risk of all-cause mortality (HR: 0.83; 95% CI: 0.75-0.91; 0%), hospitalisation for HF (HR: 0.68; 95% CI: 0.61-0.75; : 0%), CV death (HR: 0.82; 95% CI: 0.74-0.92; : 0%), and hospitalisation for HF or CV death (HR: 0.72; 95% CI: 0.66-0.78; : 0%). Subgroup analyses of the total population according to the diabetes status showed that SGLT2 inhibitors significantly reduced the risk of hospitalisation for HF (HR: 0.68; 95% CI: 0.61, 0.75; : 0%), as well as the risk of hospitalisation for HF or CV death (HR: 0.72; 95% CI: 0.66, 078; : 0%) and CV death (HR: 0.82; 95% CI: 0.74, 0.91; : 0%).
The results of this meta-analysis confirm the growing evidence in the literature of the favourable profile of SGLT2 inhibitors in cardiovascular outcomes and mortality in patients with heart failure regardless of the baseline diabetes status. This systematic review has been registered with PROSPERO (CRD42021224777).
近期的随机对照试验（RCT）显示，钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂对糖尿病患者的心血管（CV）状况具有显著的预后益处。本系统评价和荟萃分析旨在对这些药物用于心力衰竭（HF）患者的所有现有证据进行简要评估，无论其基线糖尿病状态如何。
对PubMed、科学网和Cochrane图书馆数据库从创建至2020年11月20日进行系统检索。荟萃分析纳入了八项研究，共13275例患者。对于总体人群，SGLT2抑制剂降低了全因死亡率（HR：0.83；95%CI：0.75-0.91；P<0.001）、因HF住院率（HR：0.68；95%CI：0.61-0.75；P<0.001）、CV死亡率（HR：0.82；95%CI：0.74-0.92；P<0.001）以及因HF或CV死亡住院率（HR：0.72；95%CI：0.66-0.78；P<0.001）。根据糖尿病状态对总体人群进行的亚组分析表明，SGLT2抑制剂显著降低了因HF住院的风险（HR：0.68；95%CI：0.61，0.75；P<0.001），以及因HF或CV死亡住院的风险（HR：0.72；95%CI：0.66，078；P<0.001）和CV死亡风险（HR：0.82；95%CI：0.74，0.91；P<0.001）。
本荟萃分析的结果证实了文献中越来越多的证据表明，无论基线糖尿病状态如何，SGLT2抑制剂在心力衰竭患者的心血管结局和死亡率方面具有良好的表现。本系统评价已在PROSPERO（CRD42021224777）注册。
