Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure with a Preserved Ejection Fraction: A Meta-Analysis of Randomized Controlled Trials
Background: Heart failure is prevalent worldwide. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are effective in heart failure patients with reduced ejection fraction, whether SGLT2i are effective in heart failure with preserved ejection fraction (HFpEF) remains to be determined. Methods: All r...
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| Format: | Article |
| Language: | English |
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IMR Press
2022-10-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/23/11/10.31083/j.rcm2311374 |
| _version_ | 1828097013777956864 |
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| author | Yake Lou Qi Yang Weicong Zhang Ying Yu Jing Huang |
| author_facet | Yake Lou Qi Yang Weicong Zhang Ying Yu Jing Huang |
| author_sort | Yake Lou |
| collection | DOAJ |
| description | Background: Heart failure is prevalent worldwide. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are effective in heart failure patients with reduced ejection fraction, whether SGLT2i are effective in heart failure with preserved ejection fraction (HFpEF) remains to be determined. Methods: All relevant citations in the PubMed, Embase and Cochrane databases were identified from inception to September, 2022. The primary outcome was a composite endpoint of cardiovascular death and hospitalization for heart failure (HHF). A subgroup analysis was performed according to diabetes mellitus status and the ejection fraction. Secondary endpoints were cardiovascular death, hospitalization for heart failure and all cause death. Results: Seven studies involving 11,604 patients were included in the meta-analysis. Compared with placebo, sodium-glucose cotransporter 2 inhibitors reduced the incidence of the primary outcome by 24%, with an odds ratio (OR) and 95% confidence interval (CI) 0.76 [0.69, 0.84]. For secondary outcomes, sodium-glucose cotransporter 2 inhibitors were associated with a lower incidence of hospitalization for heart failure, but not cardiovascular or all-cause death; the OR and 95% CI were 0.73 [0.66, 0.82], 0.92 [0.81, 1.04], 0.96 [0.88, 1.05], respectively. Conclusions: This study proves the clinical efficacy of SGLT2i for treatment of HFpEF patients with or without diabetes, which was mainly driven by prevention of HHF rather than cardiovascular or all-cause death. |
| first_indexed | 2024-04-11T07:39:21Z |
| format | Article |
| id | doaj.art-38391817e1ba4223a75c4ab1ccedb4ab |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-04-11T07:39:21Z |
| publishDate | 2022-10-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-38391817e1ba4223a75c4ab1ccedb4ab2022-12-22T04:36:36ZengIMR PressReviews in Cardiovascular Medicine1530-65502022-10-01231137410.31083/j.rcm2311374S1530-6550(22)00709-8Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure with a Preserved Ejection Fraction: A Meta-Analysis of Randomized Controlled TrialsYake Lou0Qi Yang1Weicong Zhang2Ying Yu3Jing Huang4Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, 400010 Chongqing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, ChinaDepartment of Ultrasound, Beijing Friendship Hospital, Capital Medical University, 100069 Beijing, ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, 400010 Chongqing, ChinaBackground: Heart failure is prevalent worldwide. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are effective in heart failure patients with reduced ejection fraction, whether SGLT2i are effective in heart failure with preserved ejection fraction (HFpEF) remains to be determined. Methods: All relevant citations in the PubMed, Embase and Cochrane databases were identified from inception to September, 2022. The primary outcome was a composite endpoint of cardiovascular death and hospitalization for heart failure (HHF). A subgroup analysis was performed according to diabetes mellitus status and the ejection fraction. Secondary endpoints were cardiovascular death, hospitalization for heart failure and all cause death. Results: Seven studies involving 11,604 patients were included in the meta-analysis. Compared with placebo, sodium-glucose cotransporter 2 inhibitors reduced the incidence of the primary outcome by 24%, with an odds ratio (OR) and 95% confidence interval (CI) 0.76 [0.69, 0.84]. For secondary outcomes, sodium-glucose cotransporter 2 inhibitors were associated with a lower incidence of hospitalization for heart failure, but not cardiovascular or all-cause death; the OR and 95% CI were 0.73 [0.66, 0.82], 0.92 [0.81, 1.04], 0.96 [0.88, 1.05], respectively. Conclusions: This study proves the clinical efficacy of SGLT2i for treatment of HFpEF patients with or without diabetes, which was mainly driven by prevention of HHF rather than cardiovascular or all-cause death.https://www.imrpress.com/journal/RCM/23/11/10.31083/j.rcm2311374sodium-glucose cotransporter 2 inhibitorscanagliflozindapagliflozinempagliflozinsotagliflozinheart failurepreserved ejection fractionreduced ejection fraction |
| spellingShingle | Yake Lou Qi Yang Weicong Zhang Ying Yu Jing Huang Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure with a Preserved Ejection Fraction: A Meta-Analysis of Randomized Controlled Trials Reviews in Cardiovascular Medicine sodium-glucose cotransporter 2 inhibitors canagliflozin dapagliflozin empagliflozin sotagliflozin heart failure preserved ejection fraction reduced ejection fraction |
| title | Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure with a Preserved Ejection Fraction: A Meta-Analysis of Randomized Controlled Trials |
| title_full | Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure with a Preserved Ejection Fraction: A Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure with a Preserved Ejection Fraction: A Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure with a Preserved Ejection Fraction: A Meta-Analysis of Randomized Controlled Trials |
| title_short | Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure with a Preserved Ejection Fraction: A Meta-Analysis of Randomized Controlled Trials |
| title_sort | efficacy of sodium glucose cotransporter 2 inhibitors in heart failure with a preserved ejection fraction a meta analysis of randomized controlled trials |
| topic | sodium-glucose cotransporter 2 inhibitors canagliflozin dapagliflozin empagliflozin sotagliflozin heart failure preserved ejection fraction reduced ejection fraction |
| url | https://www.imrpress.com/journal/RCM/23/11/10.31083/j.rcm2311374 |
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