A Systematic Review and Meta-analysis of Randomized Placebo-controlled Trials 1 Year after Starting Sodium-glucose Transporter-2 Inhibitors in Heart Failure Patients with Reduced Ventricular Ejection Fraction

Abstract

Introduction: The Sodium-Glucose Cotransporter-2 Inhibitor (SGLT-2 inhibitor) is a diabetic medication. Recently, there has been enough evidence of SGLT-2 inhibitors in type 2 diabetes mellitus, driving in an abatement in cardiovascular breakdown hospitalization. To explore SGLT-2 inhibitor in cardiovascular breakdown with lower discharge portion, we led an orderly survey and meta-examination. Strategies: We played out a methodical writing search from various electronic databases. We used keywords:” SGLT-2 inhibitor '' and “Heart Failure.” Inclusion criteria are randomized placebo-controlled trial, one-year follow-up and ejection fraction 40% or less. Composite endpoint is cardiovascular mortality with hospitalization of heart failure. Individual outcomes include all-cause mortality, cardiovascular passing, and cardiovascular breakdown hospitalization. For low heterogeneity scores, results are introduced utilizing a danger proportion (RR) with a 95 percent certainty stretch and statistical analysis using a fixed-effect model. Results: Total of two randomized control trial was selected (DAPA-HF [Dapagliflozin] and EMPEROR-Reduced [Empagliflozin]) with 8,474 patients pooled within our analysis. The results of the composite outcome compared SGLT-2 inhibitor with placebo had significant decrease in the composite of cardiovascular passing with hospitalization of cardiovascular breakdown (RR=0.78 [95% CI, 0.71–0.84], p<0.00001; I2=0%). Result of individual outcome showed significant reduction of all-cause mortality (RR=0.88 [95% CI, 0.79 – 0.98], p=0.03; I2=1%), cardiovascular mortality (RR=0.87 [95% CI, 0.77 – 0.99], p=0.03; I2=0%) and hospitalization of heart failure (RR=0.72 [95% CI, 0.65–0.81], p<0.00001; I2=0%). Conclusion: Within one year of treatment with an SGLT-2 inhibitor, the composite of cardiovascular passing with cardiovascular breakdown hospitalization, all-cause mortality, cardiovascular mortality, and cardiovascular breakdown hospitalization was significantly reduced.