Behzad Hossein, Asham Hila, Beheshtirouy Samineh, Mashayekhi Sina, Jafari Negin, Entezari-Maleki Taher
Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Perfusion. 2025 Apr;40(3):701-710. doi: 10.1177/02676591241257371. Epub 2024 May 30.
The effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on ischemia reperfusion injury (IRI) is a novel concept and only limited number of animals studies have yet been investigated. We aimed to perform a systematic review of literature to explore the clinical studies which investigated the effects of SGLT-2 inhibitors on myocardial IRI setting. We searched MEDLINE, Embase, and Cochrane Library from inception until December 7, 2023. ClinicalTrials.gov was also explored for ongoing studies. Two authors independently conducted the literature search, examined the studies, and evaluated the eligibility criteria. Any disagreements or uncertainties were resolved by the corresponding author. The search strategy followed the PICO process (Population, Intervention, Comparison, and Outcome) and Emtree was used to select relevant keywords. Of 220 articles identified from the literature research, five articles were included in the study, of which three studies lately were retracted. The remaining studies included 1229 participants, with 209 receiving SGLT-2 inhibitors and 1090 not receiving them. All of the participants were diabetic patients admitted with acute myocardial infarction (AMI), undergoing percutaneous coronary intervention (PCI). The results demonstrated that the use of SGLT-2 inhibitors is associated with lower troponin levels, and higher rates of ST resolution. The results of the studies also showed smaller infarct sizes, lower inflammatory biomarkers and improved left ventricular function at discharge among SGLT-2 inhibitor users. In line with in vivo and ex vivo findings, the results of this systematic review supported benefits of SGLT-2 inhibitors in IRI through reducing infarct size and inflammatory biomarkers. However, further clinical trials are warranted to provide robust evidence.
钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂对缺血再灌注损伤（IRI）的影响是一个新的概念，目前仅有数量有限的动物研究。我们旨在对文献进行系统综述，以探索研究SGLT-2抑制剂对心肌IRI影响的临床研究。我们检索了MEDLINE、Embase和Cochrane图书馆，检索时间从数据库建立至2023年12月7日。还在ClinicalTrials.gov上搜索了正在进行的研究。两位作者独立进行文献检索、审查研究并评估纳入标准。如有任何分歧或不确定性，由通讯作者解决。检索策略遵循PICO流程（人群、干预措施、对照和结局），并使用Emtree选择相关关键词。从文献研究中识别出的220篇文章中，有5篇被纳入研究，其中3篇最近被撤回。其余研究包括1229名参与者，其中209名接受SGLT-2抑制剂治疗，1090名未接受。所有参与者均为因急性心肌梗死（AMI）入院并接受经皮冠状动脉介入治疗（PCI）的糖尿病患者。结果表明，使用SGLT-2抑制剂与较低的肌钙蛋白水平以及较高的ST段回落率相关。研究结果还显示，SGLT-2抑制剂使用者的梗死面积较小、炎症生物标志物水平较低，出院时左心室功能改善。与体内和体外研究结果一致，该系统综述的结果支持SGLT-2抑制剂通过减少梗死面积和炎症生物标志物对IRI有益。然而，需要进一步的临床试验来提供有力证据。
