Efficacy and safety of empagliflozin in acute heart failure: a systematic review and meta-analysis.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Future cardiology Pub Date : 2025-05-05 DOI:10.1080/14796678.2025.2499374

Noman Khalid, Muhammad Adil Afzal, Muhammad Abdullah, Ata-Ul Haiy, Yezin Shamoon, Sherif Elkattawy, Muhammad Aamir Laghari, Rahul Vasudev, Shamoon E Fayez, Yasotha Rajeswaran, Gregg M Lanier, Wilbert Aronow

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引用次数: 0

Abstract

Background: Acute heart failure (AHF) is leading cause of hospitalization and mortality. Empagliflozin, a Sodium Glucose Co-transporter 2 inhibitor (SGLT-2i), has demonstrated benefits in HFrEF and HFpEF, but its role in AHF remains under-explored.

Objective: Assess safety and efficacy of empagliflozin in AHF.

Methods: A systematic review and meta-analysis adhering to PRISMA 2020 guidelines was conducted. A search on 25 February 2025, identified Phase IIb and III randomized controlled trials (RCTs) involving adults with AHF from databases like Medline®, Cochrane CENTRAL, Embase, and ClinicalTrials.gov. Outcomes included all-cause mortality, HF rehospitalization, cardiovascular deaths, and serious adverse events. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with I2 and Cochrane Q-statistic.

Results: Three RCTs (n = 824) were included. Empagliflozin reduced all-cause mortality (OR: 0.47, 95% CI: 0.29-0.78, p = 0.004) and cardiovascular death (OR: 0.56, 95% CI: 0.38-0.82, p = 0.003) compared to placebo. It also lowered serious adverse events risk (OR: 0.62, 95% CI: 0.44-0.87, p = 0.005) without significantly increasing adverse effects such as acute kidney injury, diabetic ketoacidosis, hypotension, or urinary tract infections. Sensitivity analyses confirmed these findings.

Conclusion: Empagliflozin reduces mortality in AHF with a favorable safety profile, highlighting need for further trials.

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恩格列净治疗急性心力衰竭的疗效和安全性：一项系统综述和荟萃分析。

背景：急性心力衰竭（AHF）是导致住院和死亡的主要原因。恩格列净是一种钠葡萄糖共转运蛋白2抑制剂（SGLT-2i），已被证明对HFrEF和HFpEF有益处，但其在AHF中的作用仍未得到充分研究。目的：评价恩格列净治疗AHF的安全性和有效性。方法：遵循PRISMA 2020指南进行系统评价和荟萃分析。我们于2025年2月25日检索了Medline®、Cochrane CENTRAL、Embase和ClinicalTrials.gov等数据库中涉及成人AHF的IIb期和III期随机对照试验（rct）。结果包括全因死亡率、心衰再住院、心血管死亡和严重不良事件。使用随机效应模型计算95%置信区间（ci）的优势比（ORs）。采用I2和Cochrane q统计量评估异质性。结果：纳入3项rct （n = 824）。与安慰剂相比，恩格列净降低了全因死亡率（OR: 0.47, 95% CI: 0.29-0.78, p = 0.004）和心血管死亡率（OR: 0.56, 95% CI: 0.38-0.82, p = 0.003）。它还降低了严重不良事件的风险（OR: 0.62, 95% CI: 0.44-0.87, p = 0.005），而没有显著增加急性肾损伤、糖尿病酮症酸中毒、低血压或尿路感染等不良反应。敏感性分析证实了这些发现。结论：恩帕列净降低AHF的死亡率，具有良好的安全性，需要进一步的试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.80

自引率

5.90%

发文量

期刊介绍： Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.