Long-term surrogate cardiovascular outcomes of SGLT2 inhibitor empagliflozin in chronic heart failure: a systematic review and meta-analysis

• Published in: BMC cardiovascular disorders 2024-11, Vol.24 (1), p.663-10, Article 663
• Main Authors: Yan, Qingkai, Chen, Xinrao, Yu, Changqing, Yin, Yuehui
• Format: Article
• Language: English
• Subjects: Aged; Benzhydryl Compounds - adverse effects; Benzhydryl Compounds - therapeutic use; Bias; Biomarkers - blood; Blood pressure; Blood Pressure - drug effects; Cardiovascular diseases; Chronic Disease; Clinical trials; Congestive heart failure; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Drug therapy; Ejection fraction; Empagliflozin; Exercise Tolerance - drug effects; Female; Glucose; Glucosides - adverse effects; Glucosides - therapeutic use; Heart failure; Heart Failure - diagnosis; Heart Failure - drug therapy; Heart Failure - mortality; Heart Failure - physiopathology; Humans; Long-term effects; Male; Meta-analysis; Middle Aged; Patient outcomes; Quality of Life; Randomized Controlled Trials as Topic; Recovery of Function; Sodium-glucose cotransporter; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Software; Stroke Volume - drug effects; Subgroup analysis; Systematic review; Time Factors; Treatment Outcome; Ventricle; Ventricular Function, Left - drug effects; Ventricular Remodeling - drug effects
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-024-04316-w

The sodium‒glucose cotransporter-2 (SGLT2) inhibitor empagliflozin (EMPA) has been demonstrated to reduce the risk of cardiovascular mortality or hospitalization for heart failure (HF) in patients. Nevertheless, data concerning the long-term cardiovascular effects in clinically important subgroups are scarce. A prespecified meta-analysis of randomized controlled trials (RCTs) was conducted to assess the long-term effects of EMPA on cardiovascular outcomes in HF patients, regardless of HF type and glycemic status. The assessment included parameters related to left ventricular (LV) remodeling, including the LV volume, the LV mass index (LVMI), the ejection fraction, the systolic blood pressure, and biomarkers. Moreover, the effects of the treatment on exercise capacity and quality of life (QoL) were analyzed. Furthermore, these cardiovascular parameters were evaluated in prespecified subgroups of HF patients, including type of HF, type 2 diabetes status, and duration of therapy. The quantitative meta-analysis was synthesized and analyzed via the statistical software Stata 17.0. The meta-analysis revealed that EMPA administration significantly contributed to a reduction in systolic blood pressure (SBP) (MD = 4.93 mmHg, 95% CI=[-9.67, -0.19]; P