What question did this study set out to answer?

To assess the effects of SGLT2 inhibitors on disease-specific health status, functional capacity, and cardiac function in patients with chronic heart failure with or without type 2 diabetes mellitus.

January 3, 2024Cardiovascular DiabetologyOpen Access

Effects of SGLT2 inhibitors on cardiac function and health status in chronic heart failure: a systematic review and meta-analysis

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Why the study?

Although SGLT2 inhibitors reduce clinical events in chronic heart failure, only limited studies have investigated their effects on disease-specific health status and cardiac function.

Do SGLT2 inhibitors improve cardiac function and health status in patients with chronic heart failure with or without type 2 diabetes?

Population

23,953 participants across 18 RCTs with CHF, with or without T2DM

Comparison

SGLT2 inhibitors vs control or placebo

Design

Systematic review and meta-analysis of RCTs

Authors

JCJiao ChenNanjing University of Chinese Medicine CJChunxia JiangWenzhou Medical University MGMan GuoSouthwest Medical University

Discussion

Member takes

Implication

SGLT2i improve patient-reported outcomes in CHF; extends hard-endpoint benefits to disease-specific health status.

Key Points

To assess the effects of SGLT2 inhibitors on disease-specific health status, functional capacity, and cardiac function in patients with chronic heart failure with or without type 2 diabetes mellitus.
Systematic review and meta-analysis of 18 randomized controlled trials involving 23,953 participants.
Searched PubMed, EMBASE, CENTRAL, Scopus, Web of Science, CNKI, Wanfang, and ClinicalTrials.gov.
Evaluated SGLT2 inhibitors versus control or placebo for biomarker changes, ejection fraction, functional walking distance, and questionnaire-based health scores.
SGLT2 inhibitors significantly reduced NT-proBNP levels by 136.03 pg/ml (95% CI: -253.36 to -18.70; P = 0.02) and improved left ventricular ejection fraction by 2.79% (95% CI: 0.18 to 5.39; P = 0.036).
Kansas City Cardiomyopathy Questionnaire scores showed significant gains across clinical summary (WMD = 1.70, 95% CI [1.67, 1.73]; P < 0.00001), overall summary (WMD = 1.73, 95% CI [0.94, 2.52]; P < 0.00001), and total symptom measures (WMD = 2.88, 95% CI [1.70, 4.06]; P < 0.00001).
Patients receiving SGLT2 inhibitors experienced a significant 23.98-meter increase in 6-minute walk distance (95% CI: 8.34 to 39.62; P = 0.003) compared to baseline controls.

Structured PICO

Do SGLT2 inhibitors improve cardiac function and health status in patients with chronic heart failure with or without type 2 diabetes?

Population

18 RCTs involving 23,953 participants with chronic heart failure (CHF), with or without type 2 diabetes mellitus (T2DM). Mean age 69.3 years, BMI 29.2 kg/m², baseline LVEF 43.8%, HbA1c 6.58%.

Intervention

SGLT2 inhibitors as a class (including dapagliflozin, empagliflozin, canagliflozin)

Comparator

Placebo or control groups

Outcome

Change in NT-proBNP, BNP, LVEF, Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, and 6-minute walk distance from baselinesurrogate

SGLT2 inhibitors significantly improve cardiac function (NT-proBNP, LVEF) and health status (KCCQ scores, 6-minute walk distance) in patients with chronic heart failure, regardless of diabetes status.

Limitations

Unexplained heterogeneity due to inherent differences in characteristics and definitions of the included studies
Most study participants were from Western countries, limiting applicability to other ethnic groups
Most included studies had follow-up periods of less than 52 weeks
Not all RCTs published subgroup data for all outcomes, preventing analysis by gender, diabetes status, or previous cardiovascular disease

Cite This Study

Chen et al. (2024) studied this question.

synapsesocial.com/papers/6a70a48626770c2b8de0a7dc https://doi.org/10.1186/s12933-023-02042-9

Topics

SGLT2 inhibitors in heart failure HFrEF treatment Heart failure Cardiomyopathy HFpEF management

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Effects of SGLT2 inhibitors on cardiac function and health status in chronic heart failure: a systematic review and meta-analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Effects of SGLT2 inhibitors on cardiac function and health status in chronic heart failure: a systematic review and meta-analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider