PMID- 34295696
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220425
IS  - 2223-3652 (Print)
IS  - 2223-3660 (Electronic)
IS  - 2223-3652 (Linking)
VI  - 11
IP  - 3
DP  - 2021 Jun
TI  - Factors affecting the efficacy of SGLT2is on heart failure events: a 
      meta-analysis based on cardiovascular outcome trials.
PG  - 699-706
LID - 10.21037/cdt-20-984 [doi]
AB  - BACKGROUND: The efficacy of sodium-glucose transporter 2 inhibitors (SGLT2is) on 
      heart failure outcomes is unestablished in various subgroups defined by 
      clinically important factors. We intended to evaluate the effects of six 
      important factors on the efficacy of SGLT2is on heart failure outcomes. METHODS: 
      We included cardiovascular outcome trials (CVOTs) concerning SGLT2is. We assessed 
      the heart failure composite outcome of cardiovascular death (CVD) or 
      hospitalization for heart failure (HHF). Meta-analysis was conducted stratified 
      by the following 6 factors: type of underlying diseases, type of SGLT2is, left 
      ventricular ejection fraction (LVEF) level, New York Heart Association (NYHA) 
      class, region, and race. RESULTS: Ten CVOTs were included. Compared with placebo, 
      SGLT2is reduced heart failure composite outcome by 25% [hazard ratio (HR) 0.75, 
      95% confidence interval (CI), 0.72-0.78] independent of type of underlying 
      diseases, type of SGLT2is, LVEF level, and region (P(subgroup): 0.673, 0.244, 
      0.429, and 0.127, respectively). SGLT2is led to greater reduction in the 
      composite outcome in patients with NYHA class II (HR 0.66, 95% CI, 0.59-0.74) 
      than in patients with NYHA class III or IV (HR 0.86, 95% CI, 0.75-0.99; 
      P(subgroup)=0.004), and in Black (HR 0.63, 95% CI, 0.49-0.82) and Asian (HR 0.64, 
      95% CI, 0.53-0.77) patients than in White patients (HR 0.81, 95% CI, 0.76-0.86; 
      P(subgroup)=0.016). CONCLUSIONS: SGLT2is reduce heart failure composite outcome 
      by 25% independent of type of underlying diseases, type of SGLT2is, LVEF level, 
      and region. SGLT2is lead to greater reduction in the composite outcome in 
      patients with NYHA class II than in patients with NYHA class III or IV, and in 
      Black and Asian patients than in White patients. KEYWORDS: Sodium-glucose 
      transporter 2 inhibitors (SGLT2is); heart failure; chronic kidney disease (CKD); 
      type 2 diabetes.
CI  - 2021 Cardiovascular Diagnosis and Therapy. All rights reserved.
FAU - Qiu, Mei
AU  - Qiu M
AD  - Department of General Medicine, Shenzhen Longhua District Central Hospital, 
      Shenzhen, China.
FAU - Ding, Liang-Liang
AU  - Ding LL
AD  - Department of Cardiology, First Affiliated Hospital of Yangtze University, 
      Jingzhou, China.
FAU - Zhou, Hai-Rong
AU  - Zhou HR
AD  - Department of General Medicine, Shenzhen Longhua District Central Hospital, 
      Shenzhen, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Cardiovasc Diagn Ther
JT  - Cardiovascular diagnosis and therapy
JID - 101601613
PMC - PMC8261743
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at: http://dx.doi.org/10.21037/cdt-20-984). The authors have no 
      conflicts of interest to declare.
EDAT- 2021/07/24 06:00
MHDA- 2021/07/24 06:01
PMCR- 2021/06/01
CRDT- 2021/07/23 06:50
PHST- 2020/12/06 00:00 [received]
PHST- 2021/03/28 00:00 [accepted]
PHST- 2021/07/23 06:50 [entrez]
PHST- 2021/07/24 06:00 [pubmed]
PHST- 2021/07/24 06:01 [medline]
PHST- 2021/06/01 00:00 [pmc-release]
AID - cdt-11-03-699 [pii]
AID - 10.21037/cdt-20-984 [doi]
PST - ppublish
SO  - Cardiovasc Diagn Ther. 2021 Jun;11(3):699-706. doi: 10.21037/cdt-20-984.