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Cardiovascular Effects of Stimulators of Soluble Guanylate Cyclase Administration: A Meta-analysis of Randomized

Cosimo Andrea Stamerra1, Paolo Di Giosia1, Paolo Giorgini2

  • 1Department of Internal Medicine-Mazzoni Hospital, Ascoli Piceno, Italy.

Current Atherosclerosis Reports
|April 2, 2024
PubMed

Insights

Stimulators of soluble guanylate cyclase (sGCs) significantly improve cardiac function markers like NT-pro-BNP and ejection fraction in heart failure patients. However, sGCs did not show a significant impact on all-cause mortality rates in this meta-analysis.

Area of Science:

  • Cardiology
  • Pharmacology
  • Biochemistry

Background:

  • Heart failure (HF) is a leading cause of cardiovascular mortality globally.
  • Despite advancements, HF recurrence and mortality rates remain high.
  • Soluble guanylate cyclase (sGC) plays a crucial role in vasodilation and myocardial performance through cGMP production.

Purpose of the Study:

  • To evaluate the therapeutic effects of sGC stimulators (sGCs) in patients with heart failure.
  • To analyze the impact of sGCs on cardiovascular outcomes, including NT-pro-BNP levels, ejection fraction (EF), and all-cause mortality.

Main Methods:

  • A systematic literature search was conducted across Medline, SCOPUS, and Google Scholar up to December 2022.
  • Included randomized controlled trials (RCTs) assessing cardiovascular effects and mortality in HF patients treated with sGCs.
  • Quantitative data synthesis employed a random-effects model with weighted mean difference (WMD) and 95% confidence intervals (CI).

Main Results:

  • sGCs administration resulted in a statistically significant improvement in NT-pro-BNP values (SMD: -0.258; 95% CI: -0.398, -0.118).
  • A significant improvement in ejection fraction (EF) was observed (WMD: 0.948; 95% CI: 0.485, 1.411).
  • No significant change was detected in the all-cause mortality rate (RR: 0.96; 95% CI: 0.868 to 1.072).

Conclusions:

  • sGC stimulators represent a viable therapeutic strategy for managing heart failure.
  • sGCs effectively improve cardiac performance markers in HF patients.
  • Further research may be needed to ascertain the long-term impact of sGCs on mortality in heart failure.
Abstract

Keywords:
Cardiovascular effectsEjection fractionHeart failureMortalityNT-pro-BNPOxidative stressSoluble guanylate cyclase stimulators

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