SGLT2 inhibitors reduce sudden cardiac death risk in heart failure: Meta-analysis of randomized clinical trials.
J Cardiovasc Electrophysiol
; 34(5): 1277-1285, 2023 05.
Article
en En
| MEDLINE
| ID: mdl-36950852
ABSTRACT
INTRODUCTION:
Multiple randomized controlled trials have demonstrated sodium-glucose cotransporter-2 inhibitors (SGLT2i) decrease the composite endpoint of cardiovascular death or heart failure hospitalizations in all heart failure patients. It is uncertain whether SGLT2i impacts the risk of sudden cardiac death in patients with heart failure.METHODS:
A comprehensive search was performed to identify relevant data published before August 28, 2022. Trials were included if (1) all patients had clinical heart failure (2) SGLT2i and placebo were compared (3) all patients received conventional medical therapy and (4) reported outcomes of interest (sudden cardiac death [SCD], ventricular arrhythmias, atrial arrhythmias).RESULTS:
SCD was reported in seven of the eleven trials meeting selection criteria 10 796 patients received SGLT2i and 10 796 received placebo. SGLT2i therapy was associated with a significant reduction in the risk of SCD (risk ratios [RR] 0.68; 95% confidence intervals [CI] 0.48-0.95; p = .03; I2 = 0%). Absent dedicated rhythm monitoring, there were no significant differences in the incidence of sustained ventricular arrhythmias not associated with SCD (RR 1.03; 95% CI 0.83-1.29; p = .77; I2 = 0%) or atrial arrhythmias (RR 0.91; 95% CI 0.77-1.09; p = .31; I2 = 29%) between patients receiving an SGLT2i versus placebo.CONCLUSION:
SGLT2i therapy is associated with a reduced risk of SCD in patients with heart failure receiving contemporary medical therapy. Prospective trials are needed to determine the long-term impact of SGLT2i therapy on atrial and ventricular arrhythmias.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
/
Inhibidores del Cotransportador de Sodio-Glucosa 2
/
Insuficiencia Cardíaca
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos