AUTHOR=Zhai Miaobo , Du Xin , Liu Changmei , Xu Huipu 

TITLE=The Effects of Dapagliflozin in Patients With Heart Failure Complicated With Type 2 Diabetes: A Meta-Analysis of Placebo-Controlled Randomized Trials

JOURNAL=Frontiers in Clinical Diabetes and Healthcare

VOLUME=Volume 2 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2021.703937

DOI=10.3389/fcdhc.2021.703937

ISSN=2673-6616

ABSTRACT=Background: Cardiovascular disease has become one of the main threats to people's life and health. Recently, it has been reported that sodium-glucose cotransporter 2 (SGLT2) inhibitors could reduce rates for hospitalization or urgent visit resulting in iv therapy for HF in patients with type 2 diabetes mellitus (T2DM). Methods: We searched electronic databases from inception through JULY 2020 for randomized controlled trials, using the keywords of sodium–glucose cotransporter-2 inhibitor, dapagliflozin, heart failure, cardiovascular outcomes, major adverse cardiovascular events, all-cause mortality, and cardiovascular death. Fixed-effects summary odds ratios (OR) were constructed using Mantel-Haenszel model. Results: Five trials with a total of 7857 patients ultimately met the criteria. The incidence of hospitalization for heart failure (HHF, n=4, OR=0.70; 95% CI, 0.60 to 0.81; P<0.001; I2 =0%), cardiovascular death(CVD, n=6, OR=0.84; 95% CI, 0.72 to 0.99; P=0.04; I2=0%) and all-cause mortality(ACM, n=4, OR=0.82; 95% CI, 0.71 to 0.94; P=0.005; I2 =0%) was reduced by dapagliflozin respectively in non-stratified group, without obvious heterogeneity. In HFrEF subgroup, the results of HHF (n=4, OR=0.69; 95% CI, 0.59 to 0.82; P<0.0001; I2 =0%), CVD (n=4, OR=0.75; 95% CI, 0.59 to 0.94; P=0.01; I2 =8%) and ACM (n=3, OR=0.70; 95% CI, 0.50 to 0.99; P=0.04; I2 =43%) were consistent with non-stratified group. In contrast, in the HFpEF subgroup, the incidence of CVD( n=2, OR=1.45; 95% CI, 0.95 to 2.22; P=0.08; I2 =0%) and ACM(n=2, OR=1.04; 95% CI, 0.76 to 1.43; P=0.81; I2 =0%) in dapagliflozin group showed no superiority over placebo. Conclusion: In our study, dapagliflozin was associated with a statistical reduction in the rate of heart failure hospitalization, cardiovascular death and all-cause mortality in patients with HFrEF. But in the HFpEF subgroup, dapagliflozin did not show a significant cardiovascular protective effect.