Κατεύθυνση Αναζωογόνηση
Library of the School of Health Sciences

2024-04-30

2024

Poulianitis Georgios

Ξάνθος Θεόδωρος, Καθηγητής, Σχολή Επιστημών Υγείας, Τμήμα Μαιευτικής, Πανεπιστήμιο Δυτικής Αττικής, Επιβλέπων
Ιακωβίδου Νικολέττα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Εκμεκτζόγλου Κωνσταντίνος, Επίκουρος Καθηγητής, Τμήμα Ιατρικής, Ευρωπαϊκό Πανεπιστήμιο Κύπρου

SGLT2 Αναστολείς: Μια μετα-ανάλυση για την αποτελεσματικότητα και την ασφάλειά τους σε ασθενείς με καρδιακή ανεπάρκεια με ή χωρίς σακχαρώδη διαβήτη

Greek

SGLT2-Inhibitors: a systematic review and meta-analysis of their efficacy and safety in heart failure patients with or without diabetes mellitus

INTRODUCTION: SGLT2 inhibitors have recently received approval in patients with heart failure. This systematic review and meta-analysis aims to evaluate the efficacy and safety of SGLT2 inhibitors compared with placebo in heart failure (overall; heart failure with reduced ejection fraction HFrEF; heart failure with preserved ejection fraction, HFpEF).
MATERIALS AND METHODS: A systematic search of the PubMed and Google Scholar databases was performed from March 2014 to July 2023. Pooled hazard ratios were estimated for efficacy (first heart failure hospitalization (HFH) or cardiovascular death; total HFH or cardiovascular death; first HFH; cardiovascular death; all-cause death; composite renal endpoint) and safety outcomes versus placebo.
RESULTS: After screening of 1425 items, nine randomized controlled trials were included. A significant decrease in first HFH or cardiovascular death rates was noted overall (pooled HR=0.76, 95%CI:0.72-0.81), in HFrEF (pooled HR=0.73, 95%CI:0.67-0.80) and HFpEF (pooled HR=0.81, 95%CI:0.74-0.88); a similar pattern was noted regarding the composite outcome of total HFH or cardiovascular death, as well as first HFH. However, concerning cardiovascular death a protective effect of SGLT2 inhibitors was noted in HFrEF (pooled HR=0.82, 95%CI:0.72-0.92) but not HFpEF (pooled HR=0.91, 95%CI:0.80-1.02); accordingly, regarding all-cause death lower rates were noted in HFrEF (pooled HR=0.83, 95%CI:0.74-0.92) but not HFpEF (pooled HR=0.97, 95%CI:0.88-1.06).
CONCLUSIONS: this systematic review and meta-analysis highlighted a beneficial effect of SGLT2 inhibitors in the composite outcomes of first HFH or cardiovascular death, total HFH or cardiovascular death, and the single outcome of first HFH, both in HFrEF and HFpEF. Although SGLT2 inhibitors were linked with an improvement in cardiovascular death and all-cause death in HFrEF, no significant effects were demonstrated in HFpEF. Further studies with longer follow-up periods and larger number of patients are needed for further elucidation of SGLT2 inhibitors in HFpEF. Future studies focusing specifically on HFmrEF patients would also be valuable.

Health Sciences

SGLT2 Inhibitors, Heart failure, Reduced ejection fraction, Preserved ejection fraction, Left ventricle

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Yes

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File access is restricted until 2024-10-27.

https://pergamos.lib.uoa.gr/uoa/dl/object/3397576