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The efficacy and safety of soluble guanylate cyclase modulation in patients with heart failure: a comprehensive
Mehmet Emin Arayici1,2, Hakan Gunes3, Hulya Ellidokuz1
1Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
Scientific Reports
|March 25, 2024
Summary
Soluble guanylate cyclase (sGC) modulators show no significant impact on heart failure mortality but improve quality of life. The treatment trended towards increased serious adverse events, with higher rates of hypotension and anemia observed.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Soluble guanylate cyclase (sGC) modulation is investigated for heart failure (HF).
- Previous studies indicated improved HF hospitalization but not mortality with sGC modulators.
Approach:
- A comprehensive meta-analysis of 10 randomized controlled trials (RCTs) involving 7526 HF patients was conducted.
- PRISMA guidelines were followed for the meta-analysis.
Key Points:
- sGC modulators did not significantly reduce all-cause mortality in HF patients compared to placebo (RR=0.97, p=0.62).
- A non-significant trend towards increased serious adverse events (SAEs) was observed (RR=1.10, p=0.07), with increased hypotension and anemia.
- No significant effect on NT-proBNP levels or 6-minute walk distance (6MWD) was found.
Conclusions:
- sGC modulation offers a neutral effect on HF mortality and key clinical markers.
- The primary benefit of sGC modulators in HF appears to be driven by significant improvements in quality of life domains (EQ-5D).
- Potential increases in hypotension and anemia warrant careful consideration during treatment.
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