Rahil Ali Ibrahim, Bhavsar Tirth, Fatima Romman, Rajkumar Aparajitha, Kumar Joy, Majidan Hanif Al, Gajjala Namrata, Lefranc Wodwentzky, Deeksha Fnu, Lingegowda Harshitha, Ehsan Muhammad, Ur Rehman Wajeeh, Ahmad Hasan, Ahmed Raheel
Department of Medicine, Hamad Medical Corporation, Doha, Qatar.
Department of Medicine, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.
Front Cardiovasc Med. 2025 May 1;12:1543153. doi: 10.3389/fcvm.2025.1543153. eCollection 2025.
Acute heart failure (AHF) is a serious medical condition with considerable morbidity and mortality ranging from 20%-30% within the first month following hospital admission. We aimed to evaluate the efficacy and safety of sodium-glucose cotransporter-2 (SGLT2) inhibitors administered within the first five days of hospitalization for AHF.
We utilized various electronic resources such as MEDLINE, Embase, and the Cochrane Library to retrieve relevant randomized controlled trials (RCTs). The meta-analysis was performed using Revman, where the risk ratio (RR) and mean difference (MD) with a 95% confidence interval (CI) were used for dichotomous and continuous variablesrespectively.
A total of seven trials were included in this review. SGLT2 inhibitors were associated with decreased all-cause mortality (RR = 0.61, 95% CI = 0.40, 0.95; = 0.03), worsening of HF (RR = 0.59, 95%CI = 0.36, 0.97; = 0.04), and GFR (MD: 1.05, 95% CI = 0.68, 1.43; < 0.00001) compared with the control group. There were no significant differences between the two groups regarding readmission for HF, cardiovascular mortality, AKI, hypoglycemia, hypotension, and diuretic efficiency. SGLT2 inhibitors were associated with improved KCCQ-CSS scores (MD: -3.82, 95% CI = -7.51, -0.13; = 0.04).
SGLT2 inhibitors demonstrate overall clinical benefits and a favorable safety profile in acute heart failure, although their impact on readmission rates is limited. Further research is needed to refine patient selection and optimize treatment strategies.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024571563, PROSPERO (CRD42024571563).
急性心力衰竭（AHF）是一种严重的疾病，在入院后的第一个月内，其发病率和死亡率相当高，范围在20%-30%。我们旨在评估在AHF住院治疗的前五天内给予钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂的疗效和安全性。
我们利用各种电子资源，如MEDLINE、Embase和Cochrane图书馆，检索相关的随机对照试验（RCT）。使用Revman进行荟萃分析，其中风险比（RR）和平均差（MD）以及95%置信区间（CI）分别用于二分变量和连续变量。
本综述共纳入七项试验。与对照组相比，SGLT2抑制剂与全因死亡率降低（RR = 0.61，95%CI = 0.40，0.95；P = 0.03）、心力衰竭恶化（RR = 0.59，95%CI = 0.36，0.97；P = 0.04）和肾小球滤过率（GFR）（MD：1.05，95%CI = 0.68，1.43；P < 0.00001）相关。两组在因心力衰竭再次入院、心血管死亡率、急性肾损伤、低血糖、低血压和利尿效率方面无显著差异。SGLT2抑制剂与改善堪萨斯城心肌病问卷-临床总结（KCCQ-CSS）评分相关（MD：-3.82，95%CI = -7.51，-0.13；P = 0.04）。
SGLT2抑制剂在急性心力衰竭中显示出总体临床益处和良好的安全性，尽管它们对再入院率的影响有限。需要进一步研究以优化患者选择并优化治疗策略。
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024571563，PROSPERO（CRD42024571563）。
