Alizadehasl Azin, Hakimian Hoda, Abdolkarimi Leyla, Afsari Zonooz Yasamin, Amini-Salehi Ehsan, Hosseini Jebelli Seyedeh Fatemeh, Yalameh Aliabadi Azam
Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4969-4977. doi: 10.1007/s00210-024-03739-8. Epub 2024 Dec 27.
Empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, has garnered significant interest due to its potential cardiovascular benefits, particularly in patients experiencing acute myocardial infarction (AMI) who are undergoing primary percutaneous coronary intervention (PCI). This systematic review aims to evaluate the effectiveness of Empagliflozin in improving clinical outcomes in this patient population. A systematic review of randomized controlled trials (RCTs) was conducted to assess the effects of Empagliflozin on clinical outcomes in patients with AMI undergoing primary PCI. Electronic databases, including PubMed, Scopus, Web of Science, Cochrane, and the Scientific Information Database, were searched up to July 31, 2024. The risk of bias in the included studies was evaluated using the Cochrane Collaboration criteria. Data analysis was performed using Comprehensive Meta-Analysis software version 3, with outcomes expressed as risk ratios (RR) and 95% confidence intervals (CI). Seven studies were included in the meta-analysis. The results demonstrated that Empagliflozin significantly reduced the risk of heart failure hospitalization compared to placebo, with a risk ratio of 0.48 (95% CI: 0.23-0.99; P = 0.049), indicating a 52% reduction in hospitalization risk. However, secondary outcomes showed that Empagliflozin was associated with a reduction in cardiovascular mortality (RR = 0.45; 95% CI: 0.06-3.02; P = 0.415) and the need for coronary revascularization (RR = 0.75; 95% CI: 0.15-3.59; P = 0.717), although these results did not achieve statistical significance. Empagliflozin is associated with a significant reduction in heart failure hospitalizations among patients with AMI undergoing primary PCI, while its effects on cardiovascular mortality and the necessity for coronary revascularization were not statistically significant. Despite these secondary outcomes, the favorable safety profile of Empagliflozin supports its use as a treatment option for high-risk patients following acute coronary events. Further research is warranted to investigate the long-term impact of Empagliflozin on cardiovascular outcomes in this population.
恩格列净是一种钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂，因其潜在的心血管益处而备受关注，特别是在接受直接经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）患者中。本系统评价旨在评估恩格列净对改善该患者群体临床结局的有效性。对随机对照试验（RCT）进行了系统评价，以评估恩格列净对接受直接PCI的AMI患者临床结局的影响。检索了包括PubMed、Scopus、科学网、Cochrane和科学信息数据库在内的电子数据库，检索截止至2024年7月31日。使用Cochrane协作标准评估纳入研究的偏倚风险。使用综合Meta分析软件版本3进行数据分析，结果以风险比（RR）和95%置信区间（CI）表示。七项研究纳入了荟萃分析。结果表明，与安慰剂相比，恩格列净显著降低了心力衰竭住院风险，风险比为0.48（95%CI：0.23-0.99；P = 0.049），表明住院风险降低了52%。然而，次要结局显示，恩格列净与心血管死亡率降低（RR = 0.45；95%CI：0.06-3.02；P = 0.415）和冠状动脉血运重建需求降低（RR = 0.75；95%CI：0.15-3.59；P = 0.717）相关，尽管这些结果未达到统计学显著性。恩格列净与接受直接PCI的AMI患者心力衰竭住院率显著降低相关，而其对心血管死亡率和冠状动脉血运重建必要性的影响无统计学显著性。尽管有这些次要结局，但恩格列净良好的安全性支持将其作为急性冠状动脉事件后高危患者的一种治疗选择。有必要进一步研究恩格列净对该人群心血管结局的长期影响。
