TY - JOUR
T1 - Effects and safety of SGLT2 inhibitors compared to placebo in patients with heart failure
T2 - A systematic review and meta-analysis
AU - Chambergo-Michilot, Diego
AU - Tauma-Arrué, Astrid
AU - Loli-Guevara, Silvana
N1 - Publisher Copyright:
© 2020 The Author(s)
PY - 2021/2
Y1 - 2021/2
N2 - Background: Heart failure (HF) prognosis without therapy is poor, however introduction of a range of drugs has improved it. We aimed to perform a systematic review on the effects and safety of sodium-glucose transporter 2 inhibitors (SGLT2i) in HF patients. Methods: We carried out a systematic review of randomized controlled trials (RCTs) on SGLT2i compared to placebo for HF patients. We searched in PubMed, Scopus, Web of Science and EMBASE, with no language restriction, from inception to 31 August 2020. We included nine RCTs comprising three arms (empagliflozin, dapagliflozin and placebo). Effects sizes for continuous variables were expressed as mean differences (MDs) and 95% confidence intervals (CIs). Effects sizes for dichotomous variables were expresses as risk ratio (RR) and 95% CIs. We used random-effect models with the inverse variance method. We performed subgroup meta-analyses by intervention drug and follow-up period. Results: SGLT2i significantly reduced all-cause mortality (RR: 0.88, 95%CI 0.79–0.98, I2 = 0%), cardiovascular mortality (RR: 0.87, 95%CI 0.77–0.99, I2 = 0%), HF hospitalization (RR: 0.73, 95%CI 0.66–0.81, I2 = 0%) and emergency room visits due to HF (RR: 0.40, 95%CI 0.21–0.76, I2 = 0%), as well as composite outcomes including the previous ones. Besides, it significantly improved the score of the Kansas City Cardiomyopathy Questionnaire (KCCQ, MD: 1.70, 95%CI 1.67–1.73, I2 = 54%). SGLT2i reduced any serious adverse events, blood pressure and weight. However, it increased hematocrit and creatinine. The meta-analysis of RCTs of > 12 weeks of follow-up showed that SGTL2i significantly reduced NT-proBNP. Conclusions: SGLT2i showed to improve critical outcomes in HF patients, and it is apparently safe.
AB - Background: Heart failure (HF) prognosis without therapy is poor, however introduction of a range of drugs has improved it. We aimed to perform a systematic review on the effects and safety of sodium-glucose transporter 2 inhibitors (SGLT2i) in HF patients. Methods: We carried out a systematic review of randomized controlled trials (RCTs) on SGLT2i compared to placebo for HF patients. We searched in PubMed, Scopus, Web of Science and EMBASE, with no language restriction, from inception to 31 August 2020. We included nine RCTs comprising three arms (empagliflozin, dapagliflozin and placebo). Effects sizes for continuous variables were expressed as mean differences (MDs) and 95% confidence intervals (CIs). Effects sizes for dichotomous variables were expresses as risk ratio (RR) and 95% CIs. We used random-effect models with the inverse variance method. We performed subgroup meta-analyses by intervention drug and follow-up period. Results: SGLT2i significantly reduced all-cause mortality (RR: 0.88, 95%CI 0.79–0.98, I2 = 0%), cardiovascular mortality (RR: 0.87, 95%CI 0.77–0.99, I2 = 0%), HF hospitalization (RR: 0.73, 95%CI 0.66–0.81, I2 = 0%) and emergency room visits due to HF (RR: 0.40, 95%CI 0.21–0.76, I2 = 0%), as well as composite outcomes including the previous ones. Besides, it significantly improved the score of the Kansas City Cardiomyopathy Questionnaire (KCCQ, MD: 1.70, 95%CI 1.67–1.73, I2 = 54%). SGLT2i reduced any serious adverse events, blood pressure and weight. However, it increased hematocrit and creatinine. The meta-analysis of RCTs of > 12 weeks of follow-up showed that SGTL2i significantly reduced NT-proBNP. Conclusions: SGLT2i showed to improve critical outcomes in HF patients, and it is apparently safe.
KW - Dapagliflozin (Source: MeSH NLM)
KW - Empagliflozin
KW - Heart failure
KW - Sodium glucose transporter 2 inhibitors
UR - http://www.scopus.com/inward/record.url?scp=85097712884&partnerID=8YFLogxK
U2 - 10.1016/j.ijcha.2020.100690
DO - 10.1016/j.ijcha.2020.100690
M3 - Artículo
AN - SCOPUS:85097712884
SN - 2352-9067
VL - 32
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
M1 - 100690
ER -