Efficacy and safety of sodium-glucose transporter 2 inhibitors in the treatment of heart failure: A meta-analysis / 国际生物医学工程杂志

ABSTRACT

Objective:To evaluate the efficacy and safety of sodium-glucose transporter 2 (SGLT2) inhibitors in the treatment of heart failure (HF).Methods:PubMed, ScienceDirect, EMbase, VIP, CNKI and WanFang Data were searched, randomized controlled trials (RCTs) of SGLT2 inhibitors in the treatment of heart failure were included, and quality evaluation and data extraction were carried out.Results:Ten RCTs (9 544 patients) were included. Meta-analysis showed that there were statistically significant differences between the SGLT2 inhibitor group and the control group in terms of heart failure hospitalization rate or heart failure emergency department visit rate[ RR=0.72, 95% CI(0.65, 0.81), P<0.000 01], all-cause mortality[ RR=0.87, 95% CI(0.78, 0.97), P=0.01], cardiovascular mortality[ RR=0.87, 95% CI(0.77, 0.99), P=0.03], and the reduction of N-terminal pro-brain natriuretic peptide[ RR=-133.76, 95% CI(-229.50, -38.01), P=0.006]. But there was no statistically significant difference in the change of left ventricular ejection fraction (LVEF) after the treatment ( P>0.05). The subgroup analysis showed that there were statistically significant differences between the dapagliflozin group and the heart failure group with reduced ejection fraction (HFrEF) in terms of heart failure hospitalization rate or heart failure emergency department visit rate, all-cause mortality, cardiovascular mortality, and reduced levels of NT-proBNP (all P<0.05). The patients with unknown LVEF and empagliflozin were significantly different from the control group in terms of heart failure hospitalization rate or heart failure emergency department visit rate (all P<0.05). Compared with the control group, the SGLT2 inhibitor group can reduce the risk of adverse renal reactions [ RR=0.82, 95% CI(0.68, 0.99), P=0.03]. Conclusions:SGLT2 inhibitors, especially dapagliflozin, can improve the survival rate of patients with HFrEF and have good safety.