Sodium‐glucose cotransporter 2 inhibitor effects on heart failure hospitalization and cardiac function: systematic review
| العنوان: | Sodium‐glucose cotransporter 2 inhibitor effects on heart failure hospitalization and cardiac function: systematic review |
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| المؤلفون: | Andrew Sindone, Michael Molloy‐Bland, Neale Cohen, John Atherton, Roy Rasalam, Gary Deed |
| المصدر: | ESC Heart Failure, Vol 8, Iss 5, Pp 4093-4118 (2021) ESC Heart Failure |
| بيانات النشر: | Wiley, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Cardiac function curve, medicine.medical_specialty, medicine.drug_class, Heart failure, Placebo, law.invention, Natriuresis, Randomized controlled trial, law, Cardiac structure/function, Original Research Articles, Diabetes mellitus, Internal medicine, medicine, Natriuretic peptide, Mechanisms, Humans, Diseases of the circulatory (Cardiovascular) system, Original Research Article, Sodium-Glucose Transporter 2 Inhibitors, Sodium–glucose cotransporter 2 inhibitors, Ejection fraction, business.industry, Sodium, medicine.disease, Hospitalization, Glucose, RC666-701, Cardiology, Systematic review, Randomized controlled trials, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Aims: To systematically review randomized controlled trials assessing effects of sodium–glucose cotransporter 2 inhibitors (SGLT2is) on hospitalization for heart failure (HHF) and cardiac structure/function and explore randomized controlled trial (RCT)-derived evidence for SGLT2i efficacy mechanisms in heart failure (HF). Methods and results: Systematic searches of Medline and Embase were performed. In seven trials [3730–17 160 patients; low risk of bias (RoB)], SGLT2is significantly reduced the relative risk of HHF by 27–39% vs. placebo, including in two studies in patients with HF with reduced ejection fraction with or without type-2 diabetes mellitus (T2DM). Improvements in conventional cardiovascular risk factors, including glycaemic levels, cannot account for these effects. Five trials (56–105 patients; low RoB) assessed the effects of 6–12 months of SGLT2i treatment on left ventricular structure/function; four reported significant improvements vs. placebo, and one did not. Five trials (low RoB) assessed SGLT2i treatment effects on serum N-terminal pro B-type natriuretic peptide levels; significant reductions vs. placebo were reported after 8–12 months (two studies; 3730–4744 patients) but not ≤12 weeks (three studies; 80–263 patients). Limited available RCT-derived evidence suggests various possible cardioprotective SGLT2i mechanisms, including improved haemodynamics (natriuresis and reduced interstitial fluid without blood volume contraction/neurohormonal activation) and vascular function, enhanced erythropoiesis, reduced tissue sodium and epicardial fat/inflammation, decreased sympathetic tone, and beneficial changes in cellular energetics. Conclusions: Sodium–glucose cotransporter 2 inhibitors reduce HHF regardless of T2DM status, and reversal of adverse left ventricular remodelling likely contributes to this efficacy. Hypothesis-driven mechanistic trials remain sparse, although numerous trials are planned or ongoing. |
| اللغة: | English |
| تدمد: | 2055-5822 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6c20f287b619ae3fea90244312003914 https://doaj.org/article/4fb21e3caad847648ae7d7e2dcf5391e |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....6c20f287b619ae3fea90244312003914 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20555822 |
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