The Impact of Early In-Hospital Use of SGLT2 Inhibitors on Outcomes in Patients With Acute Heart Failure: An Updated Systematic Review and Meta-Analysis
Abstract
Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, employed as antidiabetic agents, have been shown to effectively improve the prognosis of patients with chronic and stable heart failure, chronic kidney disease, and diabetes in the context of cardiovascular-renal-endocrine integrated management. However, the safety and clinical benefits of the early application of SGLT2 inhibitors in hospitalized patients with acute heart failure remain controversial. This study aimed to evaluate the safety and prognostic impact of early SGLT2 inhibitor therapy in patients with acute heart failure.
Methods: A systematic literature search of the PubMed, Web of Science, and Cochrane Library databases was conducted to identify studies on the use of SGLT2 inhibitors in acute heart failure. Two researchers independently screened studies, extracted data, and assessed the risk of bias in the included studies. The meta-analysis was performed using STATA 16.0 software (StataCorp, College Station, TX, USA).
Results: A total of 23 studies involving 47,291 patients with acute heart failure were included in this analysis (10 randomized controlled trials and 13 observational studies). Early use of SGLT2 inhibitors in hospitalized patients with acute heart failure was associated with a reduction in the incidence of composite events in the short term (relative risk (RR) = 0.64, 95% confidence interval (CI) (0.56, 0.74)), all-cause mortality (RR = 0.72, 95% CI (0.60, 0.86)), and heart failure…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 47,291 participants or records.
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