Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(10), 1137–1145. https://doi.org/10.1002/clc.24085 Xingchun Mo et al.
Points
- This study investigated the efficacy of combining sacubitril-valsartan (SV) with a sodium-glucose cotransporter-2 inhibitor (SGLT2i) in patients with heart failure with reduced ejection fraction (HFrEF).
- The meta-analysis included seven trials with a total of 16,100 patients.
- The combination of SV and SGLT2i showed better treatment outcomes than SV monotherapy.
- Patients receiving the combination therapy had a lower risk of all-cause mortality and cardiovascular mortality.
- Older HFrEF patients had higher rates of hospitalization, cardiovascular disease, and overall mortality.
Summary
This research paper aimed to investigate the efficacy of combining sacubitril-valsartan (SV) with a sodium-glucose cotransporter-2 inhibitor (SGLT2i) in patients with heart failure with reduced ejection fraction (HFrEF). While SV monotherapy has shown benefits in HFrEF patients, the potential additive effects of SGLT2i remain unknown.
A comprehensive search of multiple databases was conducted to identify relevant trials. The primary outcomes of interest were all-cause mortality, cardiovascular mortality, and mean left ventricular ejection fraction (LVEF) improvement. Secondary outcome measures included hospitalization for heart failure (HF). Meta-analysis and bias analysis were performed using Review Manager 5.2 and MedCalc software. Additionally, a meta-regression study explored the correlation between patient mean age and primary and secondary outcomes.
The meta-analysis included a total of seven trials involving 16,100 patients. The combination of SV and SGLT2i demonstrated superior treatment outcomes compared to SV monotherapy. The risk ratios for all-cause mortality, cardiovascular mortality, change in mean LVEF, and hospitalization for HF were 0.76 (0.65–0.88), 0.65 (0.49–0.86), 1.41 (−0.59 to 3.42), and 0.80 (0.64–1.01), respectively. Regression analysis indicated that older HFrEF patients had higher rates of hospitalization, cardiovascular disease, and overall mortality.
The findings suggest that combining SV with SGLT2i may provide greater cardiovascular protection and reduce the risk of death or hospitalization due to heart failure in patients with HFrEF. These results highlight the potential benefits of this combination therapy and support its consideration in managing HFrEF patients. Further research is warranted to validate these findings and explore the underlying mechanisms of this treatment approach.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24085
References Mo, X., Lu, P., & Yang, X. (2023). Efficacy of sacubitril-valsartan and SGLT2 inhibitors in heart failure with reduced ejection fraction: A systematic review and meta-analysis. Clinical Cardiology, 46(10), 1137–1145. https://doi.org/10.1002/clc.24085
