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Effect of Hypoglycemic Drugs on Patients with Heart Failure with or without T2DM: A Bayesian Network Meta-analysis

Zhaolun Zhang1, Siqi Liu1, Jiawen Xian2

  • 1Department of Cardiovascular Medicine, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China.

Reviews in Cardiovascular Medicine
|March 31, 2025
PubMed

Insights

Sotagliflozin shows promise in reducing heart failure (HF) hospitalizations and deaths in patients with and without diabetes. Further research is needed to confirm these findings on anti-diabetic drug efficacy for HF prognosis.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Anti-diabetic medications exhibit cardioprotective effects in patients with diabetes and heart failure (HF).
  • Evidence suggests these drugs may influence HF prognosis, necessitating further investigation.

Purpose of the Study:

  • To conduct a Bayesian network meta-analysis evaluating anti-diabetic drugs' impact on HF patient prognosis.
  • To compare the effectiveness of various anti-diabetic agents in HF patients, both with and without diabetes.

Main Methods:

  • Systematic search of PubMed, Embase, Cochrane, and Web of Science for randomized controlled trials (RCTs) up to November 2024.
  • Bayesian network meta-analysis to assess primary outcomes: HF re-admission, all-cause death, cardiovascular death, NT-proBNP, and LVEF.
  • Inclusion of 33 RCTs with 29,888 participants.

Main Results:

  • Sotagliflozin demonstrated the highest efficacy in reducing HF re-admission (0.84) and all-cause death (0.83).
  • Liraglutide was most effective in reducing cardiovascular death (0.97) and NT-proBNP levels (0.69).
  • Empagliflozin showed the best improvement in left ventricular ejection fraction (LVEF) (0.69).

Conclusions:

  • Sotagliflozin may be the optimal choice for managing HF patients, irrespective of diabetes status.
  • Findings should be interpreted cautiously due to the limited number of studies.
  • High-quality research is essential to validate these results and guide clinical practice.
Abstract

Keywords:
T2DMheart failurehypoglycemic drugs

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