PDF(Pubmed)
Abstract：
BACKGROUND: Sacubitril-valsartan (SV) monotherapy has been shown to help patients with Heart failure with reduced ejection fraction (HFrEF), but whether adding a sodium-glucose cotransporter-2 inhibitor (SGLT2i) improves treatment results even more is unknown.
OBJECTIVE: The goal of this study was to look at the efficacy of SV with additional SGLT2i in HFrEF patients.
METHODS: For this study, several databases, such as PubMed, EMBASE, Web of Science, and the Cochrane Library, were searched. A coherent search approach was used for data extraction. Review Manager 5.2 and MedCalc were used for conducting the meta-analysis and bias analysis. A meta-regression study correlates patient mean age with primary and secondary outcomes.
RESULTS: Seven trials totaling 16 100 patients were included in this meta-analysis. All-cause mortality, cardiovascular mortality, and improvement in mean left ventricular ejection fraction (LVEF) were the study\'s major objectives, while hospitalization for heart failure (HF) was calculated to be its secondary outcome. Our analysis showed that HFrEF patients receiving the combination of SV and SGLT2i had better treatment outcomes than the standard SV monotherapy, with risk ratios of 0.76 (0.65-0.88) for all-cause mortality, 0.65 (0.49-0.86) for cardiovascular mortality, 1.41 (-0.59 to 3.42) for change in mean LVEF, and 0.80 (0.64-1.01) for hospitalization for HF. According to the regression analysis, older HFrEF patients have higher rates of hospitalization, cardiovascular disease, and overall death.
CONCLUSIONS: The combination of SV and SGLT2i may have a greater cardiovascular protective effect and minimize the risk of death or hospitalization due to heart failure in HFrEF.
OBJECTIVE: The goal of this study was to look at the efficacy of SV with additional SGLT2i in HFrEF patients.
METHODS: For this study, several databases, such as PubMed, EMBASE, Web of Science, and the Cochrane Library, were searched. A coherent search approach was used for data extraction. Review Manager 5.2 and MedCalc were used for conducting the meta-analysis and bias analysis. A meta-regression study correlates patient mean age with primary and secondary outcomes.
RESULTS: Seven trials totaling 16 100 patients were included in this meta-analysis. All-cause mortality, cardiovascular mortality, and improvement in mean left ventricular ejection fraction (LVEF) were the study\'s major objectives, while hospitalization for heart failure (HF) was calculated to be its secondary outcome. Our analysis showed that HFrEF patients receiving the combination of SV and SGLT2i had better treatment outcomes than the standard SV monotherapy, with risk ratios of 0.76 (0.65-0.88) for all-cause mortality, 0.65 (0.49-0.86) for cardiovascular mortality, 1.41 (-0.59 to 3.42) for change in mean LVEF, and 0.80 (0.64-1.01) for hospitalization for HF. According to the regression analysis, older HFrEF patients have higher rates of hospitalization, cardiovascular disease, and overall death.
CONCLUSIONS: The combination of SV and SGLT2i may have a greater cardiovascular protective effect and minimize the risk of death or hospitalization due to heart failure in HFrEF.
摘要：
背景：已证明沙库必曲-缬沙坦（SV）单药治疗可帮助射血分数（HFrEF）降低的心力衰竭患者，但添加钠-葡萄糖协同转运蛋白-2抑制剂(SGLT2i)是否更能改善治疗结果尚不清楚.
目的：本研究的目的是观察SV与其他SGLT2i在HFrEF患者中的疗效。
方法：对于本研究，几个数据库，比如PubMed,EMBASE,WebofScience,还有Cochrane图书馆,被搜查了。使用相干搜索方法进行数据提取。使用ReviewManager5.2和MedCalc进行荟萃分析和偏倚分析。一项荟萃回归研究将患者平均年龄与主要和次要结局相关联。
结果：本荟萃分析纳入了7项试验，共16100例患者。全因死亡率,心血管死亡率，平均左心室射血分数（LVEF）的改善是研究的主要目标，而心力衰竭（HF）的住院被计算为其次要结局。我们的分析显示，接受SV和SGLT2i组合的HFrEF患者比标准SV单一疗法具有更好的治疗结果，全因死亡率的风险比为0.76（0.65-0.88），心血管死亡率为0.65（0.49-0.86），平均LVEF的变化为1.41(-0.59至3.42)，和0.80（0.64-1.01）的HF住院。根据回归分析，老年HFrEF患者的住院率较高，心血管疾病,整体死亡。
结论：SV和SGLT2i的组合可能具有更大的心血管保护作用，并将HFrEF中因心力衰竭而死亡或住院的风险降至最低。
目的：本研究的目的是观察SV与其他SGLT2i在HFrEF患者中的疗效。
方法：对于本研究，几个数据库，比如PubMed,EMBASE,WebofScience,还有Cochrane图书馆,被搜查了。使用相干搜索方法进行数据提取。使用ReviewManager5.2和MedCalc进行荟萃分析和偏倚分析。一项荟萃回归研究将患者平均年龄与主要和次要结局相关联。
结果：本荟萃分析纳入了7项试验，共16100例患者。全因死亡率,心血管死亡率，平均左心室射血分数（LVEF）的改善是研究的主要目标，而心力衰竭（HF）的住院被计算为其次要结局。我们的分析显示，接受SV和SGLT2i组合的HFrEF患者比标准SV单一疗法具有更好的治疗结果，全因死亡率的风险比为0.76（0.65-0.88），心血管死亡率为0.65（0.49-0.86），平均LVEF的变化为1.41(-0.59至3.42)，和0.80（0.64-1.01）的HF住院。根据回归分析，老年HFrEF患者的住院率较高，心血管疾病,整体死亡。
结论：SV和SGLT2i的组合可能具有更大的心血管保护作用，并将HFrEF中因心力衰竭而死亡或住院的风险降至最低。
