Treatment with sodium-glucose cotransporter 2 (SGLT2) inhibitors is associated with significant improvements in cardiac function and health status in patients with chronic heart failure (CHF), with and without type 2 diabetes, a 2016 study showed. This was revealed in a study published in 2017. Cardiovascular Diabetology.

Although SGLT2 inhibitors were developed for type 2 diabetes, previous research has shown that SGLT2 inhibitor use is associated with a lower risk of cardiovascular death, heart failure hospitalization, myocardial infarction, and all-cause mortality. I support it. However, data regarding the early effects of his SGLT2 inhibitors on cardiac function remain limited.

To assess the current body of evidence regarding the use of SGLT2 inhibitors in patients with CHF, researchers conducted a systematic review and meta-analysis of randomized controlled trials. Inclusion criteria were adult participants with CHF, with or without type 2 diabetes, and a comparison of cardiac function and health status between treatment and placebo groups.

Results included changes in B-type natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP), the proportion of participants with significant decreases in BNPP or NT-proBNP, and heart failure disease-specific Includes changes in health status. by Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical summary score, change in his 6-minute walk distance from baseline, and change in left ventricular ejection fraction (LVEF).

The analysis included a total of 18 trials involving 23,953 patients, of whom 11,986 received an SGLT2 inhibitor and 11,967 received a placebo. The mean age of the patients was 69.3 years, and the mean body mass index (BMI) was 29.2 kg/m2.²mean baseline LVEF was 43.8%, mean glycated hemoglobin (HbA)_1c) 6.58%.

Compared to placebo, SGLT2 inhibitor treatment was associated with a significant decrease in NT-proBNP (mean difference) [MD], -136.03 pg/mL. 95% CI, -253.36 to -18.70. P =.021). An NT-proBNP reduction of at least 20% was observed in 37.1% and 27.1% of the SGLT2 inhibitor and placebo groups, respectively (risk ratio) [RR]1.45; 95% CI, 0.92-2.29; P =.072).

No significant effect of SGLT2 inhibitor treatment on BNP was observed.

SGLT2 inhibitor and placebo treatment significantly improved LVEF (MD, 2.79%; 95% CI, 0.18-5.39; P =.036). Subgroup analyzes revealed no significant differences between participants under 65 years of age and those over 65 years of age.

The researchers also noted the following significant effects when comparing SGLT2 inhibitor treatment with placebo:

• KCCQ Clinical Summary Score (Weighted MD) [WMD]1.7; 95% CI, 1.67-1.73; P <.00001);
• KCCQ-Total Symptom Score (WMD, 2.88; 95% CI, 1.7-4.06; P <.00001); and
• 6-minute walk distance (WMD, 23.98 m, 95% CI, 8.34-39.62; P =.003).

Study limitations include inability to account for all possible study heterogeneity, lack of diversity beyond participants from Western countries, and follow-up periods of less than 52 weeks in the majority of included studies. can be mentioned.

The researchers concluded, “These findings demonstrate that SGLT2 inhibitor treatment improves NT-proBNP and health status (as assessed by the Kansas City Cardiomyopathy Questionnaire and 6-minute walking distance) in patients with and without CHF. “This suggests that it provides an optimal strategy.” [type 2 diabetes]”

This article was originally published on Endocrinology Advisor