Safety of sodium‐glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta‐analysis
Abstract Sodium–glucose cotransporter‐2 inhibitors (SGLT2is) reduce morbidity and mortality for heart failure (HF) patients and are recommended as cornerstones for their medical therapy. Utilization in clinical practice remains low for multiple reasons, one of which may be adverse events. We investi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-04-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14633 |
| _version_ | 1797242803585024000 |
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| author | Hamidreza Soleimani Behrad Saeedian Yeganeh Pasebani Nastaran Babajani Amirreza Pashapour Yeganeh Pegah Bahirai Hossein Navid Ahmad Amin Marc D. Samsky Micheal G. Nanna Kaveh Hosseini |
| author_facet | Hamidreza Soleimani Behrad Saeedian Yeganeh Pasebani Nastaran Babajani Amirreza Pashapour Yeganeh Pegah Bahirai Hossein Navid Ahmad Amin Marc D. Samsky Micheal G. Nanna Kaveh Hosseini |
| author_sort | Hamidreza Soleimani |
| collection | DOAJ |
| description | Abstract Sodium–glucose cotransporter‐2 inhibitors (SGLT2is) reduce morbidity and mortality for heart failure (HF) patients and are recommended as cornerstones for their medical therapy. Utilization in clinical practice remains low for multiple reasons, one of which may be adverse events. We investigated the incidence of these events to see if they are associated with SGLT2i use. A systematic search was performed in databases, including PubMed, Embase, Cochrane Library, Clinicaltrials.gov, and WHO's International Clinical Trials Registry Platform. Relevant randomized controlled trial studies assessing the safety outcomes of SGLT2i in HF patients were included in this study. We conducted the common‐effect meta‐analysis to estimate the relative risk (RR) and 95% confidence interval (CI) of safety outcomes in SGLT2i compared with placebo. Eighteen studies were included in the meta‐analysis composed of 12 925 HF patients taking an SGLT2i and 12 747 taking a placebo. The meta‐analysis indicated that the all‐cause mortality and serious adverse events (SAEs) were lower in the SGLT2i group (RR, 0.91; 95% CI, 0.85–0.97; P = 0.005, I2 = 0%; and RR, 0.92; 95% CI, 0.90–0.95; P < 0.001, I2 = 43%, respectively). Volume depletion and genitourinary infections were more prevalent in the SGLT2i group (RR, 1.17; 95% CI, 1.06–1.28; P = 0.001, I2 = 0%; and RR, 1.27; 95% CI, 1.13–1.43; P < 0.001, I2 = 17%, respectively). Our meta‐analysis demonstrated that using SGLT2is in HF patients was correlated with reduced mortality and SAEs, with a more prominent effect in HF with reduced ejection fraction patients and those taking dapagliflozin. |
| first_indexed | 2024-04-24T18:45:02Z |
| format | Article |
| id | doaj.art-3280496dda1741a2afdb5410ae781340 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-24T18:45:02Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-3280496dda1741a2afdb5410ae7813402024-03-27T06:48:03ZengWileyESC Heart Failure2055-58222024-04-0111263764810.1002/ehf2.14633Safety of sodium‐glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta‐analysisHamidreza Soleimani0Behrad Saeedian1Yeganeh Pasebani2Nastaran Babajani3Amirreza Pashapour Yeganeh4Pegah Bahirai5Hossein Navid6Ahmad Amin7Marc D. Samsky8Micheal G. Nanna9Kaveh Hosseini10Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranSchool of Medicine Tehran University of Medical Sciences Tehran IranRajaie Cardiovascular Medical and Research Center Iran University of Medical Sciences Tehran IranSchool of Medicine Tehran University of Medical Sciences Tehran IranSchool of Medicine Tehran University of Medical Sciences Tehran IranShahid Beheshti University of Medical Science Tehran IranCardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranRajaie Cardiovascular Medical and Research Center Iran University of Medical Sciences Tehran IranSection of Cardiovascular Medicine Yale University School of Medicine New Haven CT USASection of Cardiovascular Medicine Yale University School of Medicine New Haven CT USACardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran IranAbstract Sodium–glucose cotransporter‐2 inhibitors (SGLT2is) reduce morbidity and mortality for heart failure (HF) patients and are recommended as cornerstones for their medical therapy. Utilization in clinical practice remains low for multiple reasons, one of which may be adverse events. We investigated the incidence of these events to see if they are associated with SGLT2i use. A systematic search was performed in databases, including PubMed, Embase, Cochrane Library, Clinicaltrials.gov, and WHO's International Clinical Trials Registry Platform. Relevant randomized controlled trial studies assessing the safety outcomes of SGLT2i in HF patients were included in this study. We conducted the common‐effect meta‐analysis to estimate the relative risk (RR) and 95% confidence interval (CI) of safety outcomes in SGLT2i compared with placebo. Eighteen studies were included in the meta‐analysis composed of 12 925 HF patients taking an SGLT2i and 12 747 taking a placebo. The meta‐analysis indicated that the all‐cause mortality and serious adverse events (SAEs) were lower in the SGLT2i group (RR, 0.91; 95% CI, 0.85–0.97; P = 0.005, I2 = 0%; and RR, 0.92; 95% CI, 0.90–0.95; P < 0.001, I2 = 43%, respectively). Volume depletion and genitourinary infections were more prevalent in the SGLT2i group (RR, 1.17; 95% CI, 1.06–1.28; P = 0.001, I2 = 0%; and RR, 1.27; 95% CI, 1.13–1.43; P < 0.001, I2 = 17%, respectively). Our meta‐analysis demonstrated that using SGLT2is in HF patients was correlated with reduced mortality and SAEs, with a more prominent effect in HF with reduced ejection fraction patients and those taking dapagliflozin.https://doi.org/10.1002/ehf2.14633SGLT2iSodium–glucose cotransporter‐2 inhibitorsHeart failureSafety outcomesMeta‐analysisSystematic review |
| spellingShingle | Hamidreza Soleimani Behrad Saeedian Yeganeh Pasebani Nastaran Babajani Amirreza Pashapour Yeganeh Pegah Bahirai Hossein Navid Ahmad Amin Marc D. Samsky Micheal G. Nanna Kaveh Hosseini Safety of sodium‐glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta‐analysis ESC Heart Failure SGLT2i Sodium–glucose cotransporter‐2 inhibitors Heart failure Safety outcomes Meta‐analysis Systematic review |
| title | Safety of sodium‐glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta‐analysis |
| title_full | Safety of sodium‐glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta‐analysis |
| title_fullStr | Safety of sodium‐glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta‐analysis |
| title_full_unstemmed | Safety of sodium‐glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta‐analysis |
| title_short | Safety of sodium‐glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta‐analysis |
| title_sort | safety of sodium glucose cotransporter 2 inhibitors drugs among heart failure patients a systematic review and meta analysis |
| topic | SGLT2i Sodium–glucose cotransporter‐2 inhibitors Heart failure Safety outcomes Meta‐analysis Systematic review |
| url | https://doi.org/10.1002/ehf2.14633 |
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