Yamani Naser, Shaikh Fahd Niaz, Sarfraz Saba, Khan Haider Kamal, Wasim Muhammad Fahad, Paracha Anousheh Awais, Almas Talal, Mookadam Farouk, Unzek Samuel
Department of Medicine, John H Stroger Jr. Hospital of Cook County, Chicago, IL, USA.
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Ann Med Surg (Lond). 2021 Sep 8;70:102796. doi: 10.1016/j.amsu.2021.102796. eCollection 2021 Oct.
Recent data suggest that the prevalence of heart failure has increased to approximately 23 million people globally. With increasing advancement in pharmacotherapeutics, Sodium-Glucose Cotransporter-2 inhibitors (SGLT2i) have garnered attention among clinicians to treat Heart failure with reduced ejection fraction (HFrEF) in diabetic as well as non-diabetic patients.
MEDLINE, Scopus, Embase and Cochrane CENTRAL database were searched using relevant keywords and MeSH terms. Studies were considered only if they were randomized in nature and had a sample size >1000 HF patients.
Our comprehensive search strategy yielded 864 articles, of which three RCTs met the inclusion criteria with a total population of 9696. Pooled analysis revealed an association between the use of SGLT2i and decreased frequency of primary outcome irrespective of background ARNI use (HR 0.73, 95% CI [0.58-0.93], p = 0.0106; HR 0.73, 95% CI [0.66-0.81], p < 0.0001).
This meta-analysis provides substantial evidence, to safely use SGLT2i atop ARNI therapy in select HF patients to further improve outcomes.
近期数据表明，全球心力衰竭患病率已增至约2300万人。随着药物治疗的不断进步，钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）已引起临床医生的关注，用于治疗糖尿病和非糖尿病患者射血分数降低的心力衰竭（HFrEF）。
使用相关关键词和医学主题词（MeSH）检索MEDLINE、Scopus、Embase和Cochrane CENTRAL数据库。仅纳入随机对照研究，且样本量>1000例心力衰竭患者。
我们的综合检索策略共检索到864篇文章，其中三项随机对照试验符合纳入标准，总样本量为9696例。汇总分析显示，无论是否使用背景血管紧张素受体脑啡肽酶抑制剂（ARNI），使用SGLT2i均与主要结局发生频率降低相关（风险比[HR]0.73，95%置信区间[CI][0.58-0.93]，p = 0.0106；HR 0.73，95%CI[0.66-0.81]，p < 0.0001）。
这项荟萃分析提供了充分证据，表明在特定心力衰竭患者中，在ARNI治疗基础上安全使用SGLT2i可进一步改善预后。
