College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Int J Cardiol. 2024 Sep 1;410:132239. doi: 10.1016/j.ijcard.2024.132239. Epub 2024 Jun 7.
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are anti-hyperglycemic drugs and have been proven to have cardiovascular protective effects for patients with heart failure regardless of their diabetes status. However, the benefit of SGLT2i following myocardial infarction (MI) remains incompletely established. This review aimed to investigate the impact of SGLT2i on NT-proBNP levels and structural changes post-MI.
Medline, ClinicalTrial.gov, Scopus, and Directory of open-access journals were searched to retrieve the relevant articles. Eligible studies were randomized clinical trials that assessed NT-proBNP and cardiac structural changes in patients who received SGLT2i compared to placebo following MI. Two reviewers independently screened articles, extracted data, and assessed study quality.
Four studies were included in this review, including patients with and without diabetes. While two studies showed no marked decrease from the baseline in NT-proBNP levels between the SGLT2i group and the control group, two studies reported a substantial reduction. The meta-analysis included three of these studies, with a total of 238 participants. The meta-analysis did not find a statistically significant drop in NT-proBNP levels post-MI in the SGLT2 inhibitors group compared to placebo (pooled SMD = 0.16, 95% CI 0.57-0.26, P 0.45). Furthermore, different echocardiographic parameters were reported in the included trials, yet no meta-analysis could be conducted to assess the influence of SGLT2i on cardiac remodeling post-MI.
SGLT2i did not result in a statistically significant reduction of NT-proBNP level subsequent to myocardial infarction. A knowledge gap exists regarding the impact of these agents on cardiac remodeling post-MI. Future high-quality clinical trials are needed to provide more robust evidence.
钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2i）是一种降血糖药物，已被证明对心力衰竭患者具有心血管保护作用，无论其糖尿病状况如何。然而，SGLT2i 在心梗后的获益仍不完全明确。本综述旨在探讨 SGLT2i 对心梗后 NT-proBNP 水平和结构变化的影响。
通过 Medline、ClinicalTrial.gov、Scopus 和开放获取期刊目录检索相关文献，纳入评估 SGLT2i 与安慰剂相比对心梗后患者 NT-proBNP 和心脏结构变化影响的随机临床试验。两位评审员独立筛选文章、提取数据并评估研究质量。
本综述纳入了 4 项研究，包括有糖尿病和无糖尿病的患者。其中 2 项研究显示 SGLT2i 组与对照组之间 NT-proBNP 水平从基线没有显著下降，而另外 2 项研究则报告了显著下降。3 项研究的荟萃分析纳入了 238 名患者，但并未发现 SGLT2i 组与安慰剂组相比心梗后 NT-proBNP 水平有统计学意义的降低（汇总 SMD=-0.16，95%CI 0.57-0.26，P=0.45）。此外，纳入研究报告了不同的超声心动图参数，但无法进行荟萃分析评估 SGLT2i 对心梗后心脏重构的影响。
SGLT2i 不能显著降低心梗后 NT-proBNP 水平。目前尚不清楚这些药物对心梗后心脏重构的影响。需要进行高质量的临床试验来提供更有力的证据。
