钠-葡萄糖协同转运蛋白2抑制剂在急性心肌梗死中的心血管结局：一项荟萃分析。
Cardiovascular Outcome of the SGLT2 Inhibitor in Acute Myocardial Infarction: A Meta-Analysis.
作者信息
Hu Siqi, Tang Ting, Yu Qingwen, Tong Xuhan, You Yao, Zhang Shenghui, Chen Chen, Tang Jiake, Wang Chunyi, Wang Hu, Fu Xinyan, Chen Juan, Zhang Xingwei, Wang Mingwei, Liu Ling
机构信息
Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Zhejiang Key Laboratory of Medical Epigenetics, School of Basic Medical Sciences, Hangzhou Institute of Cardiovascular Diseases, Engineering Research Center of Mobile Health Management System & Ministry of Education, Hangzhou Normal University, 310015 Hangzhou, Zhejiang, China.
Department of Cardiology, Hangzhou Lin'an Fourth People's Hospital, 311321 Hangzhou, Zhejiang, China.
出版信息
Rev Cardiovasc Med. 2025 Feb 19;26(2):26136. doi: 10.31083/RCM26136. eCollection 2025 Feb.
BACKGROUND
Unexpected cardiovascular events are likely to occur within a short period following an acute myocardial infarction (AMI). The sodium-glucose co-transporter 2 inhibitor (SGLT2-I) is a recently recommended drug for the treatment of AMI. However, its role in the risk of the outcomes following an AMI, including all-cause death and heart failure readmission, remains controversial. Therefore, in this study, we explored the effect of SGLT2-Is on cardiovascular outcomes after an AMI.
METHODS
PubMed, Web of Science, and Embase were searched without language restrictions to retrieve case-control studies published before April 2024. Citations were independently screened by two authors, and the studies meeting the predefined inclusion criteria were retained. Data on author names, year of publication, location of the study group, gender and age of participants, outcome assessment, adjusted odds ratios (ORs) and 95% confidence intervals (CIs), and the follow-up period were extracted.
RESULTS
Eight studies were eligible for inclusion, and these studies showed that the use of SGLT2-Is after an AMI was significantly associated with a lower risk of hospitalization for heart failure (OR: 0.66, 95% CI 0.57-0.76, < 0.01) and a lower incidence of major cardiovascular adverse events (OR: 0.79, 95% CI 0.70-0.89, < 0.01), but was unrelated to a lower incidence of all-cause mortality (OR: 0.84, 95% CI 0.69-1.02, = 0.07).
CONCLUSIONS
Compared with placebo, SGLT2-I therapy following an AMI can reduce the risk of heart failure hospitalization and the incidence of major cardiovascular adverse events, but has no effect on all-cause mortality.
THE PROSPERO REGISTRATION
CRD42024542335, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024542335.
背景
急性心肌梗死（AMI）后短期内可能发生意外心血管事件。钠-葡萄糖协同转运蛋白2抑制剂（SGLT2-I）是最近推荐用于治疗AMI的药物。然而，其在AMI后包括全因死亡和心力衰竭再入院等结局风险中的作用仍存在争议。因此，在本研究中，我们探讨了SGLT2-I对AMI后心血管结局的影响。
方法
检索PubMed、Web of Science和Embase，无语言限制，以检索2024年4月之前发表的病例对照研究。由两位作者独立筛选文献，保留符合预定义纳入标准的研究。提取作者姓名、发表年份、研究组地点、参与者性别和年龄、结局评估、调整后的比值比（OR）和95%置信区间（CI）以及随访期的数据。
结果
八项研究符合纳入标准，这些研究表明，AMI后使用SGLT2-I与心力衰竭住院风险较低（OR：0.66，95%CI 0.57-0.76，<0.01）和主要心血管不良事件发生率较低（OR：0.79，95%CI 0.70-0.89，<0.01）显著相关，但与全因死亡率较低的发生率无关（OR：0.84，95%CI 0.69-1.02，=0.07）。
结论
与安慰剂相比，AMI后SGLT2-I治疗可降低心力衰竭住院风险和主要心血管不良事件的发生率，但对全因死亡率无影响。
PROSPERO注册：CRD42024542335，https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024542335
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