Sodium-glucose cotransporter-2 inhibitors in acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials.

Autor: Coelho Meine M; School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil., Santo P; Diagnostic Imaging and Specialized Diagnosis Unit, University Hospital of Federal University of São Carlos, 111, Luís Vaz de Camões Street - Vila Celina, São Carlos, SP, 13566-448, Brazil. paulaaesanto@hotmail.com., Dolovitsch de Oliveira F; School of Medicine, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil., Lenci Marques G; Postgraduate Program in Internal Medicine and Health Sciences, Federal University of Paraná, Curitiba, Brazil., Spadoni Barboza J; Division of Cardiology, University of Illinois, Chicago, USA.
Jazyk: angličtina
Zdroj: Heart failure reviews [Heart Fail Rev] 2025 Jan; Vol. 30 (1), pp. 219-226. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1007/s10741-024-10457-z
Abstrakt: We aimed to assess the efficacy and safety of sodium-glucose cotransporter-2 inhibitors (SGLT2i) versus placebo, initiated within the hospitalization period, in addition to habitual treatment, for treating adult patients with confirmed acute myocardial infarction (AMI). We also conducted subgroup analysis by diabetes mellitus (DM) status and type of AMI. We systematically searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs). The primary outcome was hospitalization for heart failure (HF). The secondary outcomes were all-cause death, cardiovascular death, and serious adverse events (AEs). We pooled risk ratios (RR) with a 95% confidence interval (CI) for binary outcomes. The between-study variance was assessed using tau 2 statistics. We included five RCTs, encompassing 11,211 patients. SGLT2i significantly reduced the risk of hospitalization for HF compared to placebo (RR 0.73; 95% CI [0.61, 0.88]). However, the risk of all-cause death (RR 1.05; 95% CI [0.78, 1.41]) and cardiovascular death (RR 1.04; 95% CI [0.84, 1.29]) was similar between the groups, as well as the risk of serious AEs (RR 1.01; 95% CI [0.90, 1.14]). In the subgroup analysis by DM status and type of AMI, there were no significant subgroup differences for the outcomes of hospitalization for HF and all-cause death. In patients with AMI, treatment with SGLT2i is safe and significantly reduces the risk of hospitalization for HF, but it has no impact on all-cause death and cardiovascular death compared to placebo.
Competing Interests: Declarations. Competing interests: Dr. Joaquim Spadoni Barboza is a consultant to Abiomed and Boston Scientific. Dr. Gustavo Lenci Marques has served as Principal Investigator in studies sponsored by AstraZeneca and Bayer. All other authors report no relationships that could be construed as a conflict of interest. Guarantor of the article: All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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