Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trials
BackgroundAcute heart failure (AHF) is a serious medical condition with considerable morbidity and mortality ranging from 20%–30% within the first month following hospital admission. We aimed to evaluate the efficacy and safety of sodium-glucose cotransporter-2 (SGLT2) inhibitors administered within...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1543153/full |
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| author | Ali Ibrahim Rahil Tirth Bhavsar Romman Fatima Aparajitha Rajkumar Joy Kumar Hanif Al Majidan Namrata Gajjala Wodwentzky Lefranc Fnu Deeksha Harshitha Lingegowda Muhammad Ehsan Wajeeh Ur Rehman Hasan Ahmad Raheel Ahmed |
| author_facet | Ali Ibrahim Rahil Tirth Bhavsar Romman Fatima Aparajitha Rajkumar Joy Kumar Hanif Al Majidan Namrata Gajjala Wodwentzky Lefranc Fnu Deeksha Harshitha Lingegowda Muhammad Ehsan Wajeeh Ur Rehman Hasan Ahmad Raheel Ahmed |
| author_sort | Ali Ibrahim Rahil |
| collection | DOAJ |
| description | BackgroundAcute heart failure (AHF) is a serious medical condition with considerable morbidity and mortality ranging from 20%–30% within the first month following hospital admission. We aimed to evaluate the efficacy and safety of sodium-glucose cotransporter-2 (SGLT2) inhibitors administered within the first five days of hospitalization for AHF.MethodsWe utilized various electronic resources such as MEDLINE, Embase, and the Cochrane Library to retrieve relevant randomized controlled trials (RCTs). The meta-analysis was performed using Revman, where the risk ratio (RR) and mean difference (MD) with a 95% confidence interval (CI) were used for dichotomous and continuous variablesrespectively.ResultsA total of seven trials were included in this review. SGLT2 inhibitors were associated with decreased all-cause mortality (RR = 0.61, 95% CI = 0.40, 0.95; P = 0.03), worsening of HF (RR = 0.59, 95%CI = 0.36, 0.97;P = 0.04), and GFR (MD: 1.05, 95% CI = 0.68, 1.43; P < 0.00001) compared with the control group. There were no significant differences between the two groups regarding readmission for HF, cardiovascular mortality, AKI, hypoglycemia, hypotension, and diuretic efficiency. SGLT2 inhibitors were associated with improved KCCQ-CSS scores (MD: −3.82, 95% CI = −7.51, −0.13; P = 0.04).ConclusionSGLT2 inhibitors demonstrate overall clinical benefits and a favorable safety profile in acute heart failure, although their impact on readmission rates is limited. Further research is needed to refine patient selection and optimize treatment strategies.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024571563, PROSPERO (CRD42024571563). |
| format | Article |
| id | doaj-art-d0d5661be6b340f0addd22d40dc1cf26 |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-d0d5661be6b340f0addd22d40dc1cf262025-08-20T02:55:57ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15431531543153Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trialsAli Ibrahim Rahil0Tirth Bhavsar1Romman Fatima2Aparajitha Rajkumar3Joy Kumar4Hanif Al Majidan5Namrata Gajjala6Wodwentzky Lefranc7Fnu Deeksha8Harshitha Lingegowda9Muhammad Ehsan10Wajeeh Ur Rehman11Hasan Ahmad12Raheel Ahmed13Department of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, IndiaDepartment of Medicine, Shadan Institute of Medical Sciences, Hyderabad, IndiaDepartment of Medicine, Government Kilpauk Medical College, Chennai, IndiaDepartment of Medicine, Kasturba Medical College, Manipal, IndiaDepartment of Medicine, Universitas Padjadjaran, Bandung, IndonesiaDepartment of Medicine, Government Kilpauk Medical College, Chennai, IndiaDepartment of Medicine, University Notre-Dame of Haiti, P-au-P, Haiti/Medicine, Lakeside Medical Center, Belle-Glade, FL, United StatesDepartment of Medicine, Government Medical College, Patiala, IndiaDepartment of Environmental Health, Johns Hopkins University, Baltimore, MD, United States0Department of Medicine, King Edward Medical University, Lahore, Pakistan1Department of Medicine, United Health Services, Johnson City, NY, United States2National Heart and Lung Institute, Imperial College London, London, United Kingdom2National Heart and Lung Institute, Imperial College London, London, United KingdomBackgroundAcute heart failure (AHF) is a serious medical condition with considerable morbidity and mortality ranging from 20%–30% within the first month following hospital admission. We aimed to evaluate the efficacy and safety of sodium-glucose cotransporter-2 (SGLT2) inhibitors administered within the first five days of hospitalization for AHF.MethodsWe utilized various electronic resources such as MEDLINE, Embase, and the Cochrane Library to retrieve relevant randomized controlled trials (RCTs). The meta-analysis was performed using Revman, where the risk ratio (RR) and mean difference (MD) with a 95% confidence interval (CI) were used for dichotomous and continuous variablesrespectively.ResultsA total of seven trials were included in this review. SGLT2 inhibitors were associated with decreased all-cause mortality (RR = 0.61, 95% CI = 0.40, 0.95; P = 0.03), worsening of HF (RR = 0.59, 95%CI = 0.36, 0.97;P = 0.04), and GFR (MD: 1.05, 95% CI = 0.68, 1.43; P < 0.00001) compared with the control group. There were no significant differences between the two groups regarding readmission for HF, cardiovascular mortality, AKI, hypoglycemia, hypotension, and diuretic efficiency. SGLT2 inhibitors were associated with improved KCCQ-CSS scores (MD: −3.82, 95% CI = −7.51, −0.13; P = 0.04).ConclusionSGLT2 inhibitors demonstrate overall clinical benefits and a favorable safety profile in acute heart failure, although their impact on readmission rates is limited. Further research is needed to refine patient selection and optimize treatment strategies.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024571563, PROSPERO (CRD42024571563).https://www.frontiersin.org/articles/10.3389/fcvm.2025.1543153/fullSGLT2 inhibitorsacute heart failurede-novo heart failuresystematic reviewmeta-analysis |
| spellingShingle | Ali Ibrahim Rahil Tirth Bhavsar Romman Fatima Aparajitha Rajkumar Joy Kumar Hanif Al Majidan Namrata Gajjala Wodwentzky Lefranc Fnu Deeksha Harshitha Lingegowda Muhammad Ehsan Wajeeh Ur Rehman Hasan Ahmad Raheel Ahmed Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trials Frontiers in Cardiovascular Medicine SGLT2 inhibitors acute heart failure de-novo heart failure systematic review meta-analysis |
| title | Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Efficacy and safety of SGLT2 inhibitors in acute heart failure: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | efficacy and safety of sglt2 inhibitors in acute heart failure a systematic review and meta analysis of randomized controlled trials |
| topic | SGLT2 inhibitors acute heart failure de-novo heart failure systematic review meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1543153/full |
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