Key result
SGLT2 inhibitors did not significantly reduce NT-proBNP levels compared to placebo following myocardial infarction (SMD 0.16; 95% CI 0.57-0.26; P=0.45).
Why the study?
Although SGLT2 inhibitors provide cardiovascular protection in heart failure, their benefit on NT-proBNP levels and structural changes following myocardial infarction remains incompletely established.
Do SGLT2 inhibitors reduce NT-proBNP levels and improve cardiac structural changes in patients following myocardial infarction?
Meta-Analysis (n=238)
Do SGLT2 inhibitors reduce NT-proBNP levels and improve cardiac structural changes in patients following myocardial infarction?
Standardized Mean Difference: 0.16 (95% CI 0.57–0.26)
p-value: p=0.45
SGLT2 inhibitors did not significantly reduce NT-proBNP levels following myocardial infarction compared to placebo in this meta-analysis of 238 patients.
No NT-proBNP reduction with SGLT2 inhibitors post-MI; challenges HF biomarker expectations and leaves remodeling effects open for dedicated trials.
BACKGROUND: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are anti-hyperglycemic drugs and have been proven to have cardiovascular protective effects for patients with heart failure regardless of their diabetes status. However, the benefit of SGLT2i following myocardial infarction (MI) remains incompletely established. This review aimed to investigate the impact of SGLT2i on NT-proBNP levels and structural changes post-MI. METHOD: Medline, ClinicalTrial.gov, Scopus, and Directory of open-access journals were searched to retrieve the relevant articles. Eligible studies were randomized clinical trials that assessed NT-proBNP and cardiac structural changes in patients who received SGLT2i compared to placebo following MI. Two reviewers independently screened articles, extracted data, and assessed study quality. RESULT: Four studies were included in this review, including patients with and without diabetes. While two studies showed no marked decrease from the baseline in NT-proBNP levels between the SGLT2i group and the control group, two studies reported a substantial reduction. The meta-analysis included three of these studies, with a total of 238 participants. The meta-analysis did not find a statistically significant drop in NT-proBNP levels post-MI in the SGLT2 inhibitors group compared to placebo (pooled SMD = 0.16, 95% CI 0.57-0.26, P 0.45). Furthermore, different echocardiographic parameters were reported in the included trials, yet no meta-analysis could be conducted to assess the influence of SGLT2i on cardiac remodeling post-MI. CONCLUSION: SGLT2i did not result in a statistically significant reduction of NT-proBNP level subsequent to myocardial infarction. A knowledge gap exists regarding the impact of these agents on cardiac remodeling post-MI. Future high-quality clinical trials are needed to provide more robust evidence.
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Banjar et al. (2024) conducted a meta-analysis in Myocardial infarction (n=238). Sodium-glucose co-transporter 2 inhibitors (SGLT2i) vs. Placebo was evaluated on NT-proBNP levels post-MI (SMD 0.16, 95% CI 0.57-0.26, p=0.45). SGLT2 inhibitors did not significantly reduce NT-proBNP levels compared to placebo following myocardial infarction (SMD 0.16; 95% CI 0.57-0.26; P=0.45).
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