Sodium-glucose cotransporter-2 inhibitors in acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials.

IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Heart Failure Reviews Pub Date : 2024-10-29 DOI:10.1007/s10741-024-10457-z
Matheus Coelho Meine, Paula Santo, Fabiana Dolovitsch de Oliveira, Gustavo Lenci Marques, Joaquim Spadoni Barboza
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Abstract

We aimed to assess the efficacy and safety of sodium-glucose cotransporter-2 inhibitors (SGLT2i) versus placebo, initiated within the hospitalization period, in addition to habitual treatment, for treating adult patients with confirmed acute myocardial infarction (AMI). We also conducted subgroup analysis by diabetes mellitus (DM) status and type of AMI. We systematically searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs). The primary outcome was hospitalization for heart failure (HF). The secondary outcomes were all-cause death, cardiovascular death, and serious adverse events (AEs). We pooled risk ratios (RR) with a 95% confidence interval (CI) for binary outcomes. The between-study variance was assessed using tau2 statistics. We included five RCTs, encompassing 11,211 patients. SGLT2i significantly reduced the risk of hospitalization for HF compared to placebo (RR 0.73; 95% CI [0.61, 0.88]). However, the risk of all-cause death (RR 1.05; 95% CI [0.78, 1.41]) and cardiovascular death (RR 1.04; 95% CI [0.84, 1.29]) was similar between the groups, as well as the risk of serious AEs (RR 1.01; 95% CI [0.90, 1.14]). In the subgroup analysis by DM status and type of AMI, there were no significant subgroup differences for the outcomes of hospitalization for HF and all-cause death. In patients with AMI, treatment with SGLT2i is safe and significantly reduces the risk of hospitalization for HF, but it has no impact on all-cause death and cardiovascular death compared to placebo.

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钠-葡萄糖共转运体-2 抑制剂在急性心肌梗死中的应用:随机对照试验的系统回顾和荟萃分析。
我们的目的是评估钠-葡萄糖共转运体-2 抑制剂(SGLT2i)与安慰剂的疗效和安全性,在治疗确诊急性心肌梗死(AMI)的成年患者时,除了常规治疗外,在住院期间也开始使用钠-葡萄糖共转运体-2 抑制剂。我们还根据糖尿病(DM)状态和 AMI 类型进行了亚组分析。我们系统地检索了 PubMed、Embase 和 Cochrane 图书馆中的随机对照试验 (RCT)。主要结果是心力衰竭(HF)住院。次要结果为全因死亡、心血管死亡和严重不良事件(AEs)。我们对二元结局的风险比 (RR) 和 95% 置信区间 (CI) 进行了汇总。研究间方差采用 tau2 统计法进行评估。我们纳入了五项 RCT,涉及 11,211 名患者。与安慰剂相比,SGLT2i 能显著降低因心房颤动住院的风险(RR 0.73;95% CI [0.61,0.88])。然而,两组患者的全因死亡风险(RR 1.05;95% CI [0.78,1.41])和心血管死亡风险(RR 1.04;95% CI [0.84,1.29])以及严重AEs风险(RR 1.01;95% CI [0.90,1.14])相似。在按 DM 状态和 AMI 类型进行的亚组分析中,因心房颤动住院和全因死亡的结果没有明显的亚组差异。与安慰剂相比,SGLT2i治疗急性心肌梗死患者是安全的,能显著降低因心房颤动住院的风险,但对全因死亡和心血管死亡没有影响。
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来源期刊
Heart Failure Reviews
Heart Failure Reviews 医学-心血管系统
CiteScore
10.40
自引率
2.20%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Heart Failure Reviews is an international journal which develops links between basic scientists and clinical investigators, creating a unique, interdisciplinary dialogue focused on heart failure, its pathogenesis and treatment. The journal accordingly publishes papers in both basic and clinical research fields. Topics covered include clinical and surgical approaches to therapy, basic pharmacology, biochemistry, molecular biology, pathology, and electrophysiology. The reviews are comprehensive, expanding the reader''s knowledge base and awareness of current research and new findings in this rapidly growing field of cardiovascular medicine. All reviews are thoroughly peer-reviewed before publication.
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