Wahinya Maureen, Khan Zahid
Internal Medicine, Kenyatta University Teaching, Referral and Research Hospital, Nairobi, KEN.
Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.
Cureus. 2023 Apr 10;15(4):e37388. doi: 10.7759/cureus.37388. eCollection 2023 Apr.
The global prevalence of heart failure (HF) is rising and carries a heavy social and economic burden. Type 2 diabetes mellitus (T2DM) patients are at an increased risk of incident HF even in the absence of cardiovascular risk factors. Patients with established HF are at an increased risk of death following a worsening HF event. Various trials on sodium-glucose cotransporter-2 (SGLT2) inhibitors have shown that these novel drugs prevent incident HF and reduce the risk of worsening HF in both patients with T2DM and those without diabetes. This literature review analyzed the data from 13 randomized controlled trials that met the pre-specified inclusion criteria. The aim was to compare the clinical outcomes of SGLT2 inhibitors for primary and secondary prevention of HF in patients with T2DM and those without diabetes. In addition, this study collated and summarized the patients' clinical characteristics with respect to the clinical outcome, and finally, it evaluated the safety considerations when using SGLT2 inhibitors. The data showed that SGLT2 inhibitors are effective and safe in the primary and secondary prevention of HF across a broad spectrum of patient populations and care settings. Therefore, wider eligibility for their use should be considered.
全球心力衰竭(HF)患病率正在上升,并带来沉重的社会和经济负担。2型糖尿病(T2DM)患者即使在没有心血管危险因素的情况下,发生HF的风险也会增加。已确诊HF的患者在HF事件恶化后死亡风险增加。多项关于钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂的试验表明,这些新型药物可预防T2DM患者和非糖尿病患者发生HF,并降低HF恶化风险。这篇文献综述分析了13项符合预先指定纳入标准的随机对照试验的数据。目的是比较SGLT2抑制剂在T2DM患者和非糖尿病患者中对HF进行一级和二级预防的临床结局。此外,本研究整理并总结了患者与临床结局相关的临床特征,最后评估了使用SGLT2抑制剂时的安全性考量。数据表明,SGLT2抑制剂在广泛的患者群体和护理环境中对HF的一级和二级预防有效且安全。因此,应考虑扩大其使用的适用范围。