Hasabo Elfatih A, Isik Burce, Elgadi Ammar, Eljack Mohammed Mahmmoud Fadelallah, Yacoub Magdi S, Elzomor Hesham, Sultan Sherif, Caliskan Kadir, Soliman Osama
Discipline of Medicine, School of Medicine, College of Medicine Nursing and Health Sciences, University of Galway, H91 TK33 Galway, Ireland.
Discipline of Cardiology, Saolta Healthcare Group, Galway University Hospital, Health Service Executive, H91 YR71 Galway, Ireland.
J Clin Med. 2024 Dec 5;13(23):7418. doi: 10.3390/jcm13237418.
Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) have been shown to reduce risks of clinical events in patients with heart failure (HF). However, data on the use of SGLT2-i in patients with left ventricular assist devices (LVADs) are scarce. We thought to assess the efficacy and safety of SGLT2-i in patients with LVADs. A systematic search was conducted in PubMed, Scopus, Web of Science, Embase, and Cochrane from inception to November 2024. We used all relevant words for "SGLT2-i" and "LVAD" to search in databases, and we included studies and published abstracts in peer-reviewed journals of studies that assessed SGLT2-i in patients with LVAD. Four studies and seven abstracts totaling 228 patients using SGLT2-i were included. Empagliflozin, Dapagliflozin, and Canagliflozin were the used SGLT2-i across the included studies. Pooled analysis showed that SGLT2-i significantly improved ejection fraction (EF) (Mean= 4.2, 95% CI [1.22, 7.19]) and hemoglobin A1c (HbA1c) (Mean = -0.44, 95% CI [-0.79, -0.09]) from baseline. However, no significant changes in B-type natriuretic peptide (BNP), or glomerular filtration rate (GFR) were noticed. Other outcomes of interest not included in the meta-analysis did not show significant changes, such as cardiac index (CI), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), mean arterial pressure (MAP), or mean pulmonary artery pressure (MPAP). The pooled percentage of people with driveline infection was 9%, 95% CI (3, 19). SGLT2-i effectively improves EF and HbA1c in patients using LVAD. Further adequately powered randomized studies are warranted to ascertain its clinical efficacy and safety in that unique population.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2-i）已被证明可降低心力衰竭（HF）患者临床事件的风险。然而，关于SGLT2-i在左心室辅助装置（LVAD）患者中使用的数据却很少。我们试图评估SGLT2-i在LVAD患者中的疗效和安全性。从创刊至2024年11月，我们在PubMed、Scopus、Web of Science、Embase和Cochrane中进行了系统检索。我们使用与“SGLT2-i”和“LVAD”相关的所有词汇在数据库中进行检索，并纳入了评估SGLT2-i在LVAD患者中应用的研究以及同行评审期刊上发表的摘要。共纳入4项研究和7篇摘要，总计228例使用SGLT2-i的患者。纳入的研究中使用的SGLT2-i有恩格列净、达格列净和卡格列净。汇总分析显示，SGLT2-i可使射血分数（EF）（均值=4.2，95%可信区间[1.22, 7.19]）和糖化血红蛋白（HbA1c）（均值=-0.44，95%可信区间[-0.79, -0.09]）较基线水平显著改善。然而，未观察到B型利钠肽（BNP）或肾小球滤过率（GFR）有显著变化。荟萃分析未纳入的其他感兴趣的结局指标未显示出显著变化，如心脏指数（CI）、左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、平均动脉压（MAP）或平均肺动脉压（MPAP）。发生导线感染的患者汇总百分比为9%，95%可信区间（3, 19）。SGLT2-i可有效改善LVAD患者的EF和HbA1c。有必要开展进一步足够样本量的随机研究，以确定其在该特殊人群中的临床疗效和安全性。
