SGLT-2 inhibitors on prognosis and health-related quality of life in patients with heart failure and preserved ejection fraction: A systematic review and meta-analysis.
SGLT-2 inhibitors on prognosis and health-related quality of life in patients with heart failure and preserved ejection fraction: A systematic review and meta-analysis.
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DOI：
10.3389/fcvm.2022.942125
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发表时间：
2022
影响因子：
3.6
通讯作者：
An, Fengshuang
中科院分区：
文献类型：
--
作者：
Yang, Danning;Zhang, Yu;Yan, Jie;Liu, Ming;An, Fengshuang
关键词：
保留射血分数的心力衰竭（HFpEF）正在成为心力衰竭的主要亚型，但缺乏有效的治疗方法。钠-葡萄糖共转运蛋白-2 （SGLT-2）抑制剂是一种新型的口服降糖药，对改善心血管预后有重要作用。基于当前的随机对照试验结果，我们进行了这项荟萃分析，以说明SGLT2i对HFpEF患者的治疗影响。我们系统地检索了在线数据库，共纳入了10项随机对照试验。主要转归是HFpEF患者的预后转归，包括心血管（CV）死亡和心力衰竭（HHF）住院、CV死亡率、HHF和全因死亡率的复合转归。主要次要结局包括KCCQ-TSS（堪萨斯城心肌病问卷和总症状评分）和6分钟步行测试（6MWT）的改善。所有合并结果均采用随机效应模型计算。使用卡方检验评估统计异质性，并使用i平方统计量进行量化。10项随机对照试验包括10,334例患者。与安慰剂相比，SGLT-2抑制剂组的复合结局发生率降低（HR: 0.78, 95% CI: 0.69-0.88, p = 0.00）。SGLT-2抑制剂组KCCQ-TSS的改善也更为明显（MD: 2.74, 95% CI: 1.30-4.18, p = 0.00）。6MWT无统计学差异。用SGLT-2抑制剂治疗HFpEF患者与减少CV死亡和HHF的复合结局以及改善与健康相关的生活质量相关。需要有更多证据的进一步研究来证实这一结论。
Heart failure with preserved ejection fraction (HFpEF) is becoming the main subtype of heart failure, but lacks proven effective therapies. Sodium-glucose cotransporter-2 (SGLT-2) inhibitor, a new kind of oral glucose-lowering agent, shows a great effect on improving cardiovascular outcomes. Based on the results of current RCTs, we perform this meta-analysis to illustrate the therapeutic impact of SGLT2i in HFpEF patients. We systematically searched the online database and 10 RCTs were involved. The primary outcome was the prognosis outcome of HFpEF patients, including a composite outcome of cardiovascular (CV) death and hospitalization for heart failure (HHF), CV mortality, HHF, and all-cause mortality. Main secondary outcomes included improvement of KCCQ-TSS (Kansas City Cardiomyopathy Questionnaire and total symptom score) and 6-Minute Walk Test (6MWT). All pooled results were calculated by the random-effects model. Statistical heterogeneity was assessed using the chi-squared test and was quantified using the I-squared statistic. Ten RCTs comprising 10,334 patients were involved in. Incidence of composite outcome was reduced in SGLT-2 inhibitor group compared with placebo (HR: 0.78, 95% CI: 0.69–0.88, p = 0.00). Improvement of KCCQ-TSS was also more pronounced in the SGLT-2 inhibitor group (MD: 2.74, 95% CI: 1.30–4.18, p = 0.00). No statistical difference was observed in 6MWT. Treating HFpEF patients with SGLT-2 inhibitors is associated with reducing the composite outcome of CV death and HHF and improving health-related quality of life. Further studies with more evidence are in need to confirm this conclusion.
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影响因子：
24
作者：
McGuire DK;Shih WJ;Cosentino F;Charbonnel B;Cherney DZI;Dagogo-Jack S;Pratley R;Greenberg M;Wang S;Huyck S;Gantz I;Terra SG;Masiukiewicz U;Cannon CP
通讯作者：
Cannon CP
影响因子：
120.7
作者：
Edelmann, Frank;Wachter, Rolf;Pieske, Burkert
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Pieske, Burkert
影响因子：
37.8
作者：
Butler J;Filippatos G;Jamal Siddiqi T;Brueckmann M;Böhm M;Chopra VK;Pedro Ferreira J;Januzzi JL;Kaul S;Piña IL;Ponikowski P;Shah SJ;Senni M;Vedin O;Verma S;Peil B;Pocock SJ;Zannad F;Packer M;Anker SD
通讯作者：
Anker SD
影响因子：
5.4
作者：
Croteau D;Luptak I;Chambers JM;Hobai I;Panagia M;Pimentel DR;Siwik DA;Qin F;Colucci WS
通讯作者：
Colucci WS
影响因子：
158.5
作者：
Bhatt, Deepak L.;Szarek, Michael;Pitt, Bertram
通讯作者：
Pitt, Bertram