Article Impact Level: HIGH Data Quality: STRONG Summary of Nature Medicine, 28(9), 1956–1964. https://doi.org/10.1038/s41591-022-01971-4 Dr. Pardeep Jhund et al
Points
- Individuals with cardiac death have been demonstrated to benefit from sodium-glucose co-transporter 2 (SGLT2) inhibitors, which significantly lowers the combined consequence of deteriorating HF (frequently resulting in hospitalization) or death from cardiovascular (CV) events.
- In addition to the main findings of each trial, this meta-analysis highlights the moderate decreases in the risk of MACE, cardiovascular death, and all-cause death. It gives more reliable estimates of the effect of dapagliflozin on trial endpoints.
- Every pre-determined consequence, such as severe cardiovascular problem, appeared less common in the group of dapagliflozin.
- No indication of the effect of modification by ejection fraction assessed in either a categorical or quantitative manner was found.
Summary
Regardless of ejection fraction, it is uncertain if the sodium-glucose cotransporter 2 inhibitor dapagliflozin lowers the chance of a variety of illnesses and death, resulting in patients having major cardiovascular illnesses.
A meta-analysis of two trials was performed to check dapagliflozin in patients with major cardiovascular failure. Multiple values of left ventricular ejection fraction, mainly around forty percent, were pre-determined to check the effects of treatment on endpoints and to check the impacts of dapagliflozin through an assortment of ejection fractions.
Principal cumulative outcomes of the individual trials were powered. The pooled analysis aimed to assess major elements of those consequences and significant secondary beneficiary outcomes that required more power than individual experiments.
The prime focus was on looking at how dapagliflozin affected the death rate overall and the combination of deaths from cardiovascular etiologies, heart attack, and stroke. Additionally, it was predetermined that these results would be studied in a small group of individuals to check the steadiness of dapagliflozin’s effects.
These pre-allocated endpoints were mortality from any cardiovascular event, hospitalizations from severe cardiac problems, stroke, or myocardial infarction, which are considered the most adverse cardiovascular issues. A total of 11007 participants having a mean ejection fraction of around 44% were included in the trials.
Resultantly, minimized chances of mortality were found in cardiovascular events, hospitalizations, and major adverse cardiovascular events (MACE).
There was no proof that the ejection fraction affected dapagliflozin’s effects differently. Dapagliflozin decreased the possibility of dying from major heart problems and hospitalizations for cardiac death in a patient-specified meta-analysis that included patients with all ejection fractions.
Link to the article: https://www.nature.com/articles/s41591-022-01971-4
References Jhund, P. S., Kondo, T., Butt, J. H., Docherty, K. F., Claggett, B. L., Desai, A. S., Vaduganathan, M., Gasparyan, S. B., Bengtsson, O., Lindholm, D., Petersson, M., Langkilde, A. M., de Boer, R. A., DeMets, D., Hernandez, A. F., Inzucchi, S. E., Kosiborod, M. N., Køber, L., Lam, C. S. P., … McMurray, J. J. V. (2022). Dapagliflozin across the range of ejection fraction in patients with heart failure: A patient-level, pooled meta-analysis of DAPA-HF and DELIVER. Nature Medicine, 28(9), 1956–1964. https://doi.org/10.1038/s41591-022-01971-4
