Clinical effects of sodium-glucose cotransporter 2 inhibitors combined with conventional therapy in myocardial infarction: a systematic review and meta-analysis of randomized controlled trials
Abstract
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to improve clinical outcomes in patients with heart failure; however, their efficacy and safety in patients with myocardial infarction, particularly when used in addition to conventional therapy, remain controversial. Therefore, this study aims to evaluate the effects of adding SGLT2i to conventional therapy on clinical outcomes in patients with myocardial infarction through a systematic review and meta-analysis.
Methods: We conducted a systematic review and meta-analysis to compare the effects of conventional therapy with or without SGLT2i on clinical outcomes in patients with myocardial infarction. PubMed, Web of Science, the Cochrane Library, and Embase were systematically searched.The primary outcome was the incidence of hospitalization for heart failure. Secondary outcomes included all-cause mortality, major adverse cardiovascular events (MACE), left ventricular ejection fraction (LVEF), N-terminal pro-B type natriuretic peptide (NT-proBNP), and low-density lipoprotein cholesterol (LDL-C). Safety outcomes comprised renal dysfunction, hepatic dysfunction, urinary tract infection, and glycemia-related adverse events. All analyses were conducted using a random-effects model. Prespecified subgroup analyses for the primary outcome were performed according to the presence or absence of type 2 diabetes mellitus, timing of SGLT2i initiation, and specific SGLT2i agent.
Results: This meta-analysis…
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: 22,238 participants or records.
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