Ma Wenchao, Wang Kun, Sun Leina, Su Fangcheng
Department of Emergency, Weifang People's Hospital, Weifang, Shandong, China.
Department of Respiratory and Critical Care Medicine, Weifang People's Hospital, Weifang, Shandong, China.
Br J Hosp Med (Lond). 2025 Feb 25;86(2):1-15. doi: 10.12968/hmed.2024.0336.
Dapagliflozin is a sodium-glucose cotransporter inhibitor that functions to lower blood sugar by promoting glucose excretion. We conducted a meta-analysis to assess the therapeutic efficacy of dapagliflozin in patients with type 2 diabetes mellitus complicated by coronary heart disease. The objective of this analysis is to provide additional clarity on dapagliflozin's effectiveness in this specific patient population. A systematic review of the literature was performed by searching China National Knowledge Infrastructure (CNKI), Wanfang, Wip Chinese Science, Technology Journals, China Biomedicine, Pubmed, Web of Science, and Cochrane Library. Related literature regarding the effectiveness of dapagliflozin, published since the inception of databases until October 2023, was searched and selected. Subsequent to the screening process, the Jadad scale was used to assess the quality of the gathered literature. The NoteExpress3.2 software (Beijing Aegean Music Technology Co., Ltd., Beijing, China) was utilized to manage the literature. Statistical analysis was conducted using RevMan5.4.1 software (The Cochrane Collaboration, London, UK). The -value of the Q test determined the heterogeneity of the studies, guiding the choice between fixed or random effect models for establishing the combined effect. Forest plots were used to visualize dapagliflozin's efficacy in treating patients with type 2 diabetes mellitus and coronary heart disease. A funnel plot was plotted to assess potential publication bias. Twenty-three studies were eligible for inclusion in this meta-analysis. The results revealed that dapagliflozin has better clinical efficacy (odds ratio [OR] = 3.88, 95% confidence interval [CI] 2.59 to 5.82), left ventricular ejection fraction (LVEF) (OR = 5.43, 95% CI 4.02 to 6.84). The values of left ventricular end-diastolic diameter (LVEDD) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were lower in the experimental group (OR: -4.03 and -84.65, 95% CI -5.08 to -2.98 and -127.05 to -42.25, respectively). In addition, further analysis showed that the experimental group experienced a lower incidence of adverse reactions (OR = 0.30, 95% CI 0.16 to 0.57). Dapagliflozin is more effective in controlling type 2 diabetes mellitus complicated by coronary heart disease.
达格列净是一种钠-葡萄糖协同转运蛋白抑制剂，通过促进葡萄糖排泄来降低血糖。我们进行了一项荟萃分析，以评估达格列净对2型糖尿病合并冠心病患者的治疗效果。该分析的目的是进一步明确达格列净在这一特定患者群体中的有效性。通过检索中国知网（CNKI）、万方、维普中文科技期刊、中国生物医学文献数据库、PubMed、Web of Science和Cochrane图书馆对文献进行系统综述。检索并筛选了自各数据库建立至2023年10月发表的有关达格列净有效性的相关文献。在筛选过程之后，使用Jadad量表评估所收集文献的质量。使用NoteExpress3.2软件（北京爱琴海乐之技术有限公司，中国北京）管理文献。使用RevMan5.4.1软件（Cochrane协作网，英国伦敦）进行统计分析。Q检验的P值确定研究的异质性，指导在固定效应模型或随机效应模型之间进行选择以确定合并效应。森林图用于直观展示达格列净治疗2型糖尿病合并冠心病患者的疗效。绘制漏斗图以评估潜在的发表偏倚。23项研究符合纳入本荟萃分析的条件。结果显示，达格列净具有更好的临床疗效（优势比[OR]=3.88，95%置信区间[CI]为2.59至5.82）、左心室射血分数（LVEF）（OR=5.43，95%CI为4.02至6.84）。实验组的左心室舒张末期内径（LVEDD）和N末端脑钠肽前体（NT-proBNP）值较低（OR分别为-4.03和-84.65，95%CI分别为-5.08至-2.98和-127.05至-42.25）。此外，进一步分析表明，实验组的不良反应发生率较低（OR=0.30，95%CI为0.16至0.57）。达格列净在控制2型糖尿病合并冠心病方面更有效。
