Ailing Zhang1, Xufei Luo2, Haiyang Meng1, Jian Kang1, Guijun Qin3, Yaolong Chen4,5,6,7,8, Xiaojian Zhang1. 1. Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 2. School of Public Health, Lanzhou University, Lanzhou, China. 3. Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 4. Institute of Health Data Science, Lanzhou University, Lanzhou, China. 5. Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China. 6. Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China. 7. Chinese GRADE Center, Lanzhou, China. 8. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.
Abstract
Aim: To evaluate the impact of sodium glucose cotransporter 2 inhibitors (SGLT-2i) on risk of heart failure hospitalization in patients with type 2 diabetes. Methods: We searched the PubMed, Embase, The Cochrane Library, CNKI, Wanfang, CBM, and other web knowledge databases for data from randomized controlled trials. We performed statistical analyses by using review Manager (RevMan) 5.3 and STATA 12.0 for meta-analysis. Results: Eight randomized controlled trials that compared SGLT-2i versus placebo met our inclusion criteria and were included in the study. The final meta-analysis included a total of 55,763 type 2 diabetes patients. Compared with placebo, SGLT-2i reduced the risk of heart failure hospitalization (RR, 0.63; 95% CI, 0.53 to 0.74; P < 0.00001), MACE (defined as cardiovascular death, myocardial infarction, or ischemic stroke) (RR, 0.92; 95% CI, 0.86 to 0.98; P < 0.007), cardiovascular death (RR, 0.78; 95%CI, 0.62 to 0.99; P = 0.04) in type 2 diabetes patients. SGLT-2i could reduce the risk of death from any cause (RR, 0.77; 95% CI, 0.59 to 1.01; P = 0.06) without statistical significance in type 2 diabetes patients. Conclusion: Compared with placebo, SGLT-2i may reduce the risk of heart failure hospitalization, MACE, and cardiovascular death. Therefore, SGLT-2i may be an ideal choice for type 2 diabetes mellitus patient with heart failure. These results will help inform practitioners, patients, and authorities making appropriate choices in hypoglycemic therapy clinical practice.
Aim: To evaluate the impact of sodium glucose cotransporter 2 inhibitors (SGLT-2i) on risk of heart failure hospitalization in patients with type 2 diabetes. Methods: We searched the PubMed, Embase, The Cochrane Library, CNKI, Wanfang, CBM, and other web knowledge databases for data from randomized controlled trials. We performed statistical analyses by using review Manager (RevMan) 5.3 and STATA 12.0 for meta-analysis. Results: Eight randomized controlled trials that compared SGLT-2i versus placebo met our inclusion criteria and were included in the study. The final meta-analysis included a total of 55,763 type 2 diabetespatients. Compared with placebo, SGLT-2i reduced the risk of heart failure hospitalization (RR, 0.63; 95% CI, 0.53 to 0.74; P < 0.00001), MACE (defined as cardiovascular death, myocardial infarction, or ischemic stroke) (RR, 0.92; 95% CI, 0.86 to 0.98; P < 0.007), cardiovascular death (RR, 0.78; 95%CI, 0.62 to 0.99; P = 0.04) in type 2 diabetespatients. SGLT-2i could reduce the risk of death from any cause (RR, 0.77; 95% CI, 0.59 to 1.01; P = 0.06) without statistical significance in type 2 diabetespatients. Conclusion: Compared with placebo, SGLT-2i may reduce the risk of heart failure hospitalization, MACE, and cardiovascular death. Therefore, SGLT-2i may be an ideal choice for type 2 diabetes mellituspatient with heart failure. These results will help inform practitioners, patients, and authorities making appropriate choices in hypoglycemic therapy clinical practice.
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