Effect of sex on sodium‐glucose co‐transporter‐2 antagonists and glucagon‐like peptide‐1 agonists in heart failure

Background Recent evidence suggests that medications not primarily targeting the cardiovascular (CV) system may have cardioprotective effects in patients with heart failure (HF), in particular the anti‐diabetic therapies sodium‐glucose co‐transporter‐2 (SGLT‐2) antagonists and glucagon‐like peptide‐...

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Bibliographic Details
Published in:ESC Heart Failure 2024-12, Vol.11 (6), p.3539-3550
Main Authors: Philip, Mevin A., Webb, Carolyn M., Chakraborty, Turja, Collins, Peter
Format: Article
Language:English
Subjects:
Bias
cardiovascular death
Clinical trials
Data collection
Diabetes
Ejection fraction
Female
GLP-1 receptor agonists
GLP‐1 agonist
Glucagon
Glucagon-Like Peptide 1 - agonists
Glucose
Heart failure
Heart Failure - drug therapy
hospitalization
Humans
Male
Original
Patients
Peptides
sex
Sex Factors
SGLT‐2 antagonist
Sodium-Glucose Transporter 2 Inhibitors - therapeutic use
Software
Systematic review
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Summary:Background Recent evidence suggests that medications not primarily targeting the cardiovascular (CV) system may have cardioprotective effects in patients with heart failure (HF), in particular the anti‐diabetic therapies sodium‐glucose co‐transporter‐2 (SGLT‐2) antagonists and glucagon‐like peptide‐1 (GLP‐1) agonists. We conducted a systematic review to assess the pooled evidence for the use of SGLT‐2 antagonists and GLP‐1 agonists in patients with HF and the effect of biological sex on the results. Methods MEDLINE, Embase, Cochrane Library and clinical trial databases were searched until February 2023. Randomized controlled trials (RCTs) published in English that included adult participants with HF who were randomized to an SGLT‐2 antagonist or GLP‐1 agonist with a primary or secondary outcome of HF hospitalization (HFH) or CV death were eligible for inclusion. Data pooling was undertaken using a random effects model and odds ratios (ORs) to determine the association between drug and outcome. Sub‐group analyses to investigate sex differences were conducted. Results Six RCTs were included (24 781 patients). Four studies investigated SGLT‐2 antagonists, and two studies examined GLP‐1 agonists. SGLT‐2 antagonists improved HFH {OR [95% confidence interval (CI)]: 0.69 [0.63, 0.77], P 
ISSN:2055-5822
2055-5822
DOI:10.1002/ehf2.14979