Zhaolun Zhang, Siqi Liu, Jiawen Xian, Yali Zhang, Chunyu Zhang, Zhiyuan Wang, Hongmei Deng, Jian Feng, Lei Yao
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引用次数: 0
Abstract
Background: Anti-diabetic drugs have been noted to have a cardioprotective effect in patients with diabetes and heart failure (HF). The purpose of this study was to perform a Bayesian network meta-analysis to evaluate the impact of various anti-diabetic drugs on the prognosis of HF patients with and without diabetes.
Methods: We searched PubMed, Embase, Cochrane, and Web of Science for randomized controlled trials (RCTs) published before November 2024 that investigated the use of anti-diabetic medications in patients with HF. Primary outcomes included re-admission due to HF, all-cause death, cardiovascular death, serum N-terminal pro-brain natriuretic peptide (NTpro-BNP) levels, and left ventricular ejection fraction (LVEF). A Bayesian network meta-analysis was used to compare the effectiveness of different anti-diabetic drugs.
Results: A total of 33 RCTs involving 29,888 patients were included. Sotagliflozin was the most effective in reducing the risk of re-admission due to HF and all-cause death, with a cumulative probability of 0.84 and 0.83, respectively. Liraglutide reduced the risk of cardiovascular death in HF patients with a cumulative probability of 0.97 and had the best efficacy in reducing NTpro-BNP levels with a cumulative probability of 0.69. Empagliflozin was best in improving LVEF in HF patients, with a cumulative probability of 0.69.
Conclusions: This Bayesian network meta-analysis demonstrates that sotagliflozin may be the best option for HF patients with and without diabetes. However, due to the small number of articles in this study, our results must be treated cautiously. Subsequently, there is an urgent need for more high-quality studies to validate our findings.
研究背景：降糖药物对糖尿病合并心力衰竭（HF）患者具有保护心脏的作用。本研究的目的是通过贝叶斯网络荟萃分析来评估各种抗糖尿病药物对合并和不合并糖尿病的心衰患者预后的影响。方法：我们检索PubMed、Embase、Cochrane和Web of Science，检索2024年11月之前发表的调查心衰患者使用抗糖尿病药物的随机对照试验（rct）。主要结局包括HF、全因死亡、心血管死亡、血清n -末端前脑利钠肽（NTpro-BNP）水平和左心室射血分数（LVEF）。采用贝叶斯网络meta分析比较不同抗糖尿病药物的疗效。结果：共纳入33项随机对照试验，涉及29,888例患者。Sotagliflozin在降低HF和全因死亡的再入院风险方面最有效，累积概率分别为0.84和0.83。利拉鲁肽降低心衰患者心血管死亡风险的累积概率为0.97，降低NTpro-BNP水平的累积概率为0.69，效果最佳。恩格列净改善HF患者LVEF的效果最好，累积概率为0.69。结论：本贝叶斯网络荟萃分析表明，sotagliflozin可能是合并或不合并糖尿病的心衰患者的最佳选择。然而，由于本研究的文章数量较少，我们的结果必须谨慎对待。因此，迫切需要更多高质量的研究来验证我们的发现。
期刊介绍：
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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