A Systematic Review and Meta-Analysis of the Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitor in Patients Using Left Ventricular Assist Devices

被引:0
作者
Hasabo, Elfatih A. [1 ,2 ,3 ]
Isik, Burce [4 ]
Elgadi, Ammar [5 ]
Eljack, Mohammed Mahmmoud Fadelallah [6 ]
Yacoub, Magdi S. [1 ]
Elzomor, Hesham [1 ]
Sultan, Sherif [7 ]
Caliskan, Kadir [8 ]
Soliman, Osama [1 ,2 ,3 ,9 ]
机构
[1] Univ Galway, Coll Med Nursing & Hlth Sci, Sch Med, Discipline Med, Galway H91 TK33, Ireland
[2] Galway Univ Hosp, Hlth Serv Execut, Discipline Cardiol, SAOLTA Healthcare Grp, Galway H91 YR71, Ireland
[3] Univ Galway, CORRIB CURAM Vasc Grp, Galway H91 YR71, Ireland
[4] Univ Limerick, Sch Med, Limerick V94 T9PX, Ireland
[5] Univ Khartoum, Fac Med, Khartoum 11111, Sudan
[6] Univ Bakht Alruda, Fac Med, Ad Duwaym 11112, Sudan
[7] Univ Coll Hosp, Western Vasc Inst, Dept Vasc & Endovasc Surg, Galway H91 YR71, Ireland
[8] Erasmus MC Univ, Cardiovasc Inst, Dept Cardiol, Thoraxctr,Med Ctr, NL-3015 GD Rotterdam, Netherlands
[9] Euro Heart Fdn, NL-3071 Rotterdam, Netherlands
关键词
sodium-glucose cotransporter-2 inhibitors; ventricular assist device; systematic review; meta-analysis; efficacy; safety; HEART-FAILURE; EMPAGLIFLOZIN; IMPLANTATION;
D O I
10.3390/jcm13237418
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) have been shown to reduce risks of clinical events in patients with heart failure (HF). However, data on the use of SGLT2-i in patients with left ventricular assist devices (LVADs) are scarce. We thought to assess the efficacy and safety of SGLT2-i in patients with LVADs. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Embase, and Cochrane from inception to November 2024. We used all relevant words for "SGLT2-i" and "LVAD" to search in databases, and we included studies and published abstracts in peer-reviewed journals of studies that assessed SGLT2-i in patients with LVAD. Results: Four studies and seven abstracts totaling 228 patients using SGLT2-i were included. Empagliflozin, Dapagliflozin, and Canagliflozin were the used SGLT2-i across the included studies. Pooled analysis showed that SGLT2-i significantly improved ejection fraction (EF) (Mean= 4.2, 95% CI [1.22, 7.19]) and hemoglobin A1c (HbA1c) (Mean = -0.44, 95% CI [-0.79, -0.09]) from baseline. However, no significant changes in B-type natriuretic peptide (BNP), or glomerular filtration rate (GFR) were noticed. Other outcomes of interest not included in the meta-analysis did not show significant changes, such as cardiac index (CI), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), mean arterial pressure (MAP), or mean pulmonary artery pressure (MPAP). The pooled percentage of people with driveline infection was 9%, 95% CI (3, 19). Conclusions: SGLT2-i effectively improves EF and HbA1c in patients using LVAD. Further adequately powered randomized studies are warranted to ascertain its clinical efficacy and safety in that unique population.
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页数:15
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