Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trials.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Frontiers in Cardiovascular Medicine Pub Date : 2025-05-01 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1543153

Ali Ibrahim Rahil, Tirth Bhavsar, Romman Fatima, Aparajitha Rajkumar, Joy Kumar, Hanif Al Majidan, Namrata Gajjala, Wodwentzky Lefranc, Fnu Deeksha, Harshitha Lingegowda, Muhammad Ehsan, Wajeeh Ur Rehman, Hasan Ahmad, Raheel Ahmed

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引用次数: 0

Abstract

Background: Acute heart failure (AHF) is a serious medical condition with considerable morbidity and mortality ranging from 20%-30% within the first month following hospital admission. We aimed to evaluate the efficacy and safety of sodium-glucose cotransporter-2 (SGLT2) inhibitors administered within the first five days of hospitalization for AHF.

Methods: We utilized various electronic resources such as MEDLINE, Embase, and the Cochrane Library to retrieve relevant randomized controlled trials (RCTs). The meta-analysis was performed using Revman, where the risk ratio (RR) and mean difference (MD) with a 95% confidence interval (CI) were used for dichotomous and continuous variablesrespectively.

Results: A total of seven trials were included in this review. SGLT2 inhibitors were associated with decreased all-cause mortality (RR = 0.61, 95% CI = 0.40, 0.95; P = 0.03), worsening of HF (RR = 0.59, 95%CI = 0.36, 0.97;P = 0.04), and GFR (MD: 1.05, 95% CI = 0.68, 1.43; P < 0.00001) compared with the control group. There were no significant differences between the two groups regarding readmission for HF, cardiovascular mortality, AKI, hypoglycemia, hypotension, and diuretic efficiency. SGLT2 inhibitors were associated with improved KCCQ-CSS scores (MD: -3.82, 95% CI = -7.51, -0.13; P = 0.04).

Conclusion: SGLT2 inhibitors demonstrate overall clinical benefits and a favorable safety profile in acute heart failure, although their impact on readmission rates is limited. Further research is needed to refine patient selection and optimize treatment strategies.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024571563, PROSPERO (CRD42024571563).

查看原文本刊更多论文

SGLT2抑制剂治疗急性心力衰竭的疗效和安全性：随机对照试验的系统回顾和荟萃分析

背景：急性心力衰竭（AHF）是一种严重的疾病，在入院后的第一个月内发病率和死亡率相当高，在20%-30%之间。我们的目的是评估在AHF住院前5天内使用钠-葡萄糖共转运蛋白-2 （SGLT2）抑制剂的有效性和安全性。方法：利用MEDLINE、Embase、Cochrane图书馆等多种电子资源检索相关随机对照试验（rct）。meta分析采用Revman软件进行，其中风险比（RR）和均值差（MD）分别采用95%置信区间（CI）作为二分类变量和连续变量。结果：本综述共纳入7项试验。SGLT2抑制剂与全因死亡率降低相关(RR = 0.61, 95% CI = 0.40, 0.95；P = 0.03),心力衰竭恶化(RR = 0.59, 95% CI = 0.36, 0.97; P = 0.04),和肾小球滤过率(GFR) (MD: 1.05, 95% CI = 0.68, 1.43;p = 0.04)。结论：SGLT2抑制剂在急性心力衰竭中表现出总体的临床益处和良好的安全性，尽管它们对再入院率的影响有限。需要进一步的研究来完善患者选择和优化治疗策略。系统评价注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD42024571563, PROSPERO （CRD42024571563）。

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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

期刊介绍： Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.