METHODS: Medline, ClinicalTrial.gov, Scopus, and Directory of open-access journals were searched to retrieve the relevant articles. Eligible studies were randomized clinical trials that assessed NT-proBNP and cardiac structural changes in patients who received SGLT2i compared to placebo following MI. Two reviewers independently screened articles, extracted data, and assessed study quality.
RESULTS: Four studies were included in this review, including patients with and without diabetes. While two studies showed no marked decrease from the baseline in NT-proBNP levels between the SGLT2i group and the control group, two studies reported a substantial reduction. The meta-analysis included three of these studies, with a total of 238 participants. The meta-analysis did not find a statistically significant drop in NT-proBNP levels post-MI in the SGLT2 inhibitors group compared to placebo (pooled SMD = 0.16, 95% CI 0.57-0.26, P 0.45). Furthermore, different echocardiographic parameters were reported in the included trials, yet no meta-analysis could be conducted to assess the influence of SGLT2i on cardiac remodeling post-MI.
CONCLUSIONS: SGLT2i did not result in a statistically significant reduction of NT-proBNP level subsequent to myocardial infarction. A knowledge gap exists regarding the impact of these agents on cardiac remodeling post-MI. Future high-quality clinical trials are needed to provide more robust evidence.
方法:Medline,ClinicalTrial.gov,Scopus,并搜索了开放获取期刊目录以检索相关文章。合格的研究是随机临床试验,评估接受SGLT2i的患者与MI后安慰剂相比的NT-proBNP和心脏结构变化。两名审稿人独立筛选文章,提取的数据,并评估研究质量。
结果:这篇综述包括四项研究,包括有和没有糖尿病的患者。虽然两项研究显示SGLT2i组和对照组之间的NT-proBNP水平与基线相比没有明显下降,两项研究报告大幅减少。荟萃分析包括其中三项研究,共有238人参加。荟萃分析未发现与安慰剂相比,SGLT2抑制剂组MI后NT-proBNP水平有统计学意义的下降(合并SMD=0.16,95%CI0.57-0.26,P0.45)。此外,纳入的试验报道了不同的超声心动图参数,然而,无法进行荟萃分析来评估SGLT2i对MI后心脏重构的影响.
结论:SGLT2i并未导致心肌梗死后NT-proBNP水平的显著降低。关于这些药物对MI后心脏重塑的影响存在知识空白。未来需要高质量的临床试验来提供更有力的证据。