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Effects of SGLT-2 inhibitors on health-related quality of life and exercise capacity in heart failure patients with reduced ejection fraction: A systematic review and meta-analysis
International Journal of Cardiology ( IF 3.5 ) Pub Date : 2021-10-13 , DOI: 10.1016/j.ijcard.2021.10.008
Zhiyu He 1 , Lin Yang 2 , Yutong Nie 3 , Yu Wang 3 , Yangyang Wang 3 , Xiaowei Niu 4 , Ming Bai 4 , Yali Yao 4 , Zheng Zhang 1
Affiliation  

Objective

Improving health-related quality of life (HRQoL) and exercise capacity is an important goal of treatment in heart failure (HF). However, evidence for the effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on the improvement of HRQoL and exercise capacity seems to be conflicted. We performed a systematic review and meta-analysis to evaluate the effects of SGLT-2 inhibitors on HRQL and exercise capacity in patients with heart failure and reduced ejection fraction (HFrEF).

Methods

All studies (up to March 20, 2021) evaluating the effects of SGLT-2 inhibitors on HRQoL and exercise capacity in patients with HFrEF were initially searched from four electronic search engines: PubMed, Web of Science, Cochrane Library, and SinoMed. All statistical analyses were performed with RevMan 5.4.

Results

We included 9 articles describing 7 trials with 9428 patients. SGLT-2 inhibitors group exhibited significant improvement in HRQoL assessed by Kansas City Cardiomyopathy Questionnaires (KCCQ) (MD: 2.13, 95% CI: 1.11 to 3.14, p < 0.001) and the rate of KCCQ-overall summary score improvement≥5 points (RR 1.15, 95%CI 1.08 to 1.21, P < 0.001) compared with placebo. No significant difference was observed in exercise capacity assessed by 6-min walk test distance between SGLT-2 inhibitors and placebo (MD 24.45, 95%CI -22.82 to 71.72, P = 0.31).

Conclusions

Our meta-analysis demonstrates that SGLT-2 inhibitors significantly improve HRQoL, and supports the concept that SGLT-2 inhibitors do not significantly improve exercise capacity in patients with HFrEF. Studies with larger sample sizes and longer follow-up duration are needed to determine whether the treatment with SGLT-2 inhibitors may improve exercise ability.

PROSPERO: CRD42021248346.



中文翻译:

SGLT-2抑制剂对射血分数降低心力衰竭患者健康相关生活质量和运动能力的影响:系统评价和荟萃分析

客观的

改善与健康相关的生活质量 (HRQoL) 和运动能力是心力衰竭 (HF) 治疗的重要目标。然而,钠-葡萄糖协同转运蛋白 2 (SGLT-2) 抑制剂对改善 HRQoL 和运动能力的影响的证据似乎相互矛盾。我们进行了一项系统回顾和荟萃分析,以评估 SGLT-2 抑制剂对心力衰竭和射血分数降低 (HFrEF) 患者 HRQL 和运动能力的影响。

方法

所有评估 SGLT-2 抑制剂对 HFrEF 患者 HRQoL 和运动能力影响的研究(截至 2021 年 3 月 20 日)最初都从四个电子搜索引擎中检索:PubMed、Web of Science、Cochrane Library 和 SinoMed。所有统计分析均使用 RevMan 5.4 进行。

结果

我们纳入了 9 篇文章,描述了涉及 9428 名患者的 7 项试验。SGLT-2 抑制剂组通过堪萨斯城心肌病问卷 (KCCQ) 评估的 HRQoL 显着改善(MD:2.13,95% CI:1.11 至 3.14,p  < 0.001),KCCQ-总体总分改善率≥5 分( 与安慰剂相比,RR 1.15,95%CI 1.08 至 1.21,P < 0.001)。通过 SGLT-2 抑制剂和安慰剂之间的 6 分钟步行测试距离评估的运动能力没有显着差异(MD 24.45,95%CI -22.82 至 71.72,P  = 0.31)。

结论

我们的荟萃分析表明 SGLT-2 抑制剂显着改善 HRQoL,并支持 SGLT-2 抑制剂不会显着改善 HFrEF 患者运动能力的概念。需要更大样本量和更长随访时间的研究来确定 SGLT-2 抑制剂治疗是否可以提高运动能力。

繁荣:CRD42021248346。

更新日期:2021-11-17
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