Sex differences in cardiovascular outcomes of SGLT-2 inhibitors in heart failure randomized controlled trials: A systematic review and meta-analysis
F. B. Rivera,V. Tang,D. D. De Luna,Edgar V. Lerma,Krishnaswami Vijayaraghavan,Amir Kazory,Nilay Shah,Annabelle Santos Volgman +7 more
- Vol. 26, pp 100261-100261
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In this article , the authors explored potential sex differences in primary composite outcomes among patients with heart failure treated with SGLT-2is and found that the primary composite outcome was significantly lower in females compared with males.Abstract:
In patients with heart failure (HF), randomized controlled trials (RCTs) of sodium-glucose transporter-2 inhibitors (SGLT-2is) have proven to be effective in decreasing the primary composite outcome of cardiovascular death and hospitalizations for HF. A recently published meta-analysis showed that the use of SGLT-2is among women with diabetes resulted in less reduction in primary composite outcomes compared with men. This study aims to explore potential sex differences in primary composite outcomes among patients with HF treated with SGLT-2is.We systematically searched the medical database from 2017 to 2022 and retrieved all the RCTs using SGLT-2is with specified cardiovascular outcomes. We used the PRISMA (Preferred Reporting Items for a Review and Meta-analysis) method to screen for eligibility. We evaluated the quality of studies using the Cochrane Risk of Bias tool. We pooled the hazard ratio (HR) of the primary composite outcomes in both sexes, performed a meta-analysis, and calculated the odds ratio (OR) of the primary composite outcomes based on sex.We included 5 RCTs with a total number of 21,947 patients. Of these, 7837 (35.7 %) were females. Primary composite outcomes were significantly lower in males and females taking SGLT-2is compared to placebo (males - HR 0.77; 95 % CI 0.72 to 0.84; p = 0.00001; females - HR 0.75; 95 % CI 0.67 to 0.84; p = 0.00001). Pooled data from four of the RCTs (n = 20,725) revealed a greater occurrence of the primary composite outcomes in females compared with males (OR 1.32; 95 % CI 1.17 to 1.48; p = 0.0002).SGLT-2is reduce the risk of primary composite outcomes in patients with HF, regardless of sex; however, the benefits were less pronounced in women. Further research needs to be done to better explain these observed differences in outcomes. read more
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References
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Journal ArticleDOI
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.
Theresa McDonagh,Marco Metra,Marianna Adamo,Roy S. Gardner,Andreas Baumbach,Michael Böhm,Haran Burri,Javed Butler,Jelena Čelutkienė,Ovidiu Chioncel,John G F Cleland,A J S Coats,Maria G Crespo-Leiro,Dimitrios Farmakis,Martine Gilard,Stephane Heymans,Arno W. Hoes,Tiny Jaarsma,Ewa A. Jankowska,Mitja Lainscak,Carolyn S.P. Lam,Alexander R. Lyon,John J.V. McMurray,Alexandre Mebazaa,Richard Mindham,Claudio Muneretto,Massimo F Piepoli,Susanna Price,Giuseppe M.C. Rosano,Frank Ruschitzka,Anne Kathrine Skibelund +30 more
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Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.
Salim S. Virani,Alvaro Alonso,Hugo J. Aparicio,Emelia J. Benjamin,Márcio Sommer Bittencourt,Clifton W. Callaway,April P. Carson,Alanna M. Chamberlain,Susan Cheng,Francesca N. Delling,Mitchell S.V. Elkind,Kelly R. Evenson,Jane F. Ferguson,Deepak K. Gupta,Sadiya S. Khan,Brett M. Kissela,Kristen L. Knutson,Chong D. Lee,Tené T. Lewis,Junxiu Liu,Matthew Shane Loop,Pamela L. Lutsey,Jun Ma,Jason Mackey,Seth S. Martin,David B. Matchar,Michael E. Mussolino,Sankar D. Navaneethan,Amanda M. Perak,Gregory A. Roth,Zainab Samad,Gary Satou,Emily B. Schroeder,Svati H. Shah,Christina M. Shay,Andrew Stokes,Lisa B. VanWagner,Nae Yuh Wang,Connie W. Tsao +38 more
TL;DR: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascul...
Journal ArticleDOI
[ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: what's new?]
Journal ArticleDOI
Empagliflozin in heart failure with a preserved ejection fraction
Stefan D. Anker,Javed Butler,Gerasimos Filippatos,João Pedro Ferreira,Edimar Bocchi,Michael Böhm,Hans-Peter Brunner-La Rocca,Dong-Ju Choi,Vijay K. Chopra,Eduardo Chuquiure-Valenzuela,Nadia Giannetti,Juan Esteban Gomez-Mesa,Stefan Janssens,James L. Januzzi,Jose R Gonzalez-Juanatey,Bela Merkely,Stephen J. Nicholls,Sergio V. Perrone,Ileana L. Piña,Piotr Ponikowski,Michele Senni,David K.L. Sim,Jindrich Spinar,Iain Squire,Stefano Taddei,Hiroyuki Tsutsui,Subodh Verma,Dragos Vinereanu,Jian Zhang,Peter E. Carson,Carolyn Su Ping Lam,Nikolaus Marx,Cordula Zeller,Naveed Sattar,Waheed Jamal,Sven Schnaidt,Janet Schnee,Martina Brueckmann,Stuart J. Pocock,Faiez Zannad,Milton Packer,EMPEROR-Preserved Trial Investigators +41 more
TL;DR: In this paper, a double-blind trial was conducted to evaluate the effect of empagliflozin on the risk of cardiovascular death or hospitalization for heart failure in patients with heart failure and a reduced ejection fraction.
Journal ArticleDOI
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
Paul A. Heidenreich,Biykem Bozkurt,David Aguilar,Larry A. Allen,Joni J. Byun,Monica Colvin,Anita Deswal,Mark H. Drazner,Shannon M. Dunlay,Linda R. Evers,James C. Fang,Savitri Fedson,Gregg C. Fonarow,Salim S. Hayek,Adrian F. Hernandez,Prateeti Khazanie,Michelle M. Kittleson,Christopher S. Lee,Mark S. Link,Carmelo A. Milano,Lorraine C. Nnacheta,Alexander T. Sandhu,Lynne W. Stevenson,Orly Vardeny,Amanda R. Vest,Clyde W. Yancy +25 more
TL;DR: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" as discussed by the authors provides patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure.