This value remained significant even after sensitivity analysis removing each study sequentially. 3, 6, 7 This comprised 5928 patients and showed a 23% reduction in CV death or HHF (HR = 0.77, 95% CI: 0.66, 0.91 I 2 22%) in the SGLT2 group ( Supplementary material online, Figure S6). However, as some studies included patients with left ventricular ejection fraction (LVEF) 40–50%, not fulfilling the definition of HFpEF according to the recent ESC Heart Failure guidelines, 8 we also undertook a focused pre-specified subanalysis for those studies with available data for patients with LVEF > 50%. There were no significant differences between the two groups of patients in terms of CV death (HR = 1.01, 95% CI: 0.80, 1.28 I 2 23%) ( Supplementary material online, Figure S4) and all-cause mortality (HR = 1.01, 95% CI: 0.89, 1.14 I 2 0%) ( Supplementary material online, Figure S5). The use of SGLT2 inhibitors was associated with a significant reduction in CV death or HHF (HR = 0.78, 95% CI: 0.69, 0.87 I 2 0%) ( Figure 1) and in HHF (HR = 0.71, 95% CI: 0.61, 0.84 I 2 0%) ( Supplementary material online, Figure S3) compared with placebo. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014).Įffect of SGLT2 inhibitors vs placebo on the risk of cardiovascular death or hospitalisation for heart failure for the total population.
#Transporter 2 software
The statistical analyses were conducted using the Review Manager (RevMan) software (version 5.3. Statistical heterogeneity was assessed using the I 2 statistic. A random-effects model with inverse-variance weights was used to combine the effect measures from all studies on a logarithmic scale. The hazard ratios and 95% CI given in each study were used for the meta-analysis. The characteristics of the studies included are demonstrated in Table 1. 3–7 Of those, 5046 patients received an SGLT2i, and 4680 placebo. From 9493 articles, 167 studies underwent full-text screening, a total of 5 studies and 9726 patients were included. Our primary endpoint was cardiovascular death and hospitalization for heart failure (HHF). The inclusion criteria and the detailed study selection process are shown in Supplementary material online, Figures S1 and S2. The key terms used for the search were ‘SGLT2’ or ‘Sodium-glucose cotransporter-2 inhibitors’ or ‘canagliflozin’ or ‘dapagliflozin’ or ‘empagliflozin’ or ‘ertugliflozin’ and ‘heart failure’ with at least 6 months of follow-up. We systematically searched PubMed, Embase, Cochrane and Web of Science databases from inception to 27 August 2021. The recent publication of EMPEROR-PRESEVED 3 was an instrumental time for an updated meta-analysis focused on sodium glucose co-transporter 2 inhibitors (SGLT2i) use in HFpEF. 1 Given the various subphenotypes of HFpEF, 2 this makes it difficult for a single agent to be universally beneficial. Whilst heart failure with preserved ejection fraction (HFpEF) is increasingly studied, the search for a single pharmacotherapeutic agent that will improve hard endpoints like hospitalization and mortality still continues.
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