心力衰竭患者中的SGLT2抑制剂与保存的喷射分数:随机对照试验的元分析
Akash Jaiswal1, Vikash Jaiswal2, Song Peng Ang3
1Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India.
Medicine
|September 29, 2023
概括
-葡萄糖共载体2 (SGLT2) 抑制剂显著减少心力衰竭住院. 虽然在减少心血管事件方面有效,但在本分析中,SGLT2抑制剂对全因死亡率没有显著影响.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 建议使用-葡萄糖共载体2 (SGLT2) 抑制剂治疗心力衰竭与减少喷射率 (HFrEF).
- 它们在心力衰竭中具有保存的喷射分数 (HFpEF) 的疗效仍在争论中.
- 这项分析重点关注HFpEF中SGLT2抑制剂的影响,包括DELIVER和EMPEROR-Preserved等关键试验.
研究的目的:
- 评估SGLT2抑制剂对心力衰竭患者的影响,特别是检查HFpEF的结果.
- 综合从主要临床试验研究SGLT2抑制剂在这个人群中的证据.
主要方法:
- 在PubMed,Embase,Scopus和Cochrane图书馆进行了系统的文献搜索,直到2022年8月.
- 使用随机效应模型计算出具有95%置信区间 (CI) 的危险比率 (HR).
- 统计学意义由P值<0.05和CI不超过1.0确定.
主要成果:
- 分析了包括15989名患者在内的6项研究.
- SGLT2 抑制剂显著降低了复合心血管死亡率或第一次心力衰竭住院治疗 (HR,0.80 [95% CI:0.74-0.87]) 和心力衰竭住院治疗 (HR,0.74 [95% CI:0.67-0.82]).
- 在全因死亡率 (HR,0.97 [95% CI:0.89-1.06]) 或心血管死亡率 (HR,0.96 [95% CI:0.82-1.13]) 中没有发现显著差异.
结论:
- 在被研究的人群中,SGLT2抑制剂在减少心力衰竭住院和复合心血管事件方面具有显著的益处.
- 观察到的好处并不延伸到所有原因或心血管死亡率的显著降低.
- 这些发现有助于理解SGLT2抑制剂在治疗心力衰竭患者中的作用.
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