PDF(Pubmed)
Abstract：
Anthracyclines are effective chemotherapeutic agents widely used to treat various cancers, but their use is limited by the risk of cardiotoxicity and heart failure. While strategies like dose reduction have been explored, there are no well-established therapies to mitigate this risk. Emerging evidence suggests sodium-glucose cotransporter 2 inhibitors (SGLT2i) may have cardioprotective effects, providing a rationale for investigating their potential utility in anthracycline-treated patients. We conducted a systematic review and meta-analysis to synthesize available evidence on the efficacy of SGLT2i in reducing heart failure incidence and mortality in patients undergoing anthracycline-based cancer therapy. Relevant studies were identified through comprehensive database searches and screened based on predefined criteria. Data extraction and quality assessment were performed independently by two reviewers. Four observational studies, encompassing 5,590 patients, were included. The pooled analysis showed a higher but non-significant risk of developing heart failure in the non-SGLT2i group compared to the SGLT2i group (RR = 0.67, 95% CI: 0.40-1.41). The risk of all-cause mortality was significantly lower in patients receiving SGLT2i (RR = 0.55, 95% CI: 0.39-0.77). This meta-analysis suggests SGLT2i are associated with a lower risk of mortality and heart failure incidence in anthracycline-treated patients, although larger studies are needed to confirm these findings. The mechanisms underlying these potential benefits require further elucidation. Despite limitations, this analysis highlights the promising role of SGLT2i as a cardioprotective strategy in this high-risk population.
摘要：
蒽环类药物是广泛用于治疗各种癌症的有效化学治疗剂，但是它们的使用受到心脏毒性和心力衰竭风险的限制。虽然已经探索了减少剂量等策略，目前还没有完善的治疗方法来减轻这种风险.新的证据表明，钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）可能具有心脏保护作用，为研究其在蒽环类药物治疗患者中的潜在效用提供了理论基础。我们进行了系统评价和荟萃分析，以综合SGLT2i在接受蒽环类药物治疗的患者中降低心力衰竭发生率和死亡率的有效性的现有证据。通过全面的数据库搜索确定相关研究，并根据预定义的标准进行筛选。数据提取和质量评估由两名审阅者独立进行。四项观察性研究,涵盖5,590名患者，包括在内。汇总分析显示，与SGLT2i组相比，非SGLT2i组发生心力衰竭的风险较高，但无统计学意义（RR=0.67，95％CI：0.40-1.41）。接受SGLT2i治疗的患者全因死亡风险显著降低(RR=0.55,95%CI:0.39-0.77)。这项荟萃分析提示SGLT2i与蒽环类药物治疗患者的死亡率和心力衰竭发生率较低相关。尽管需要更大的研究来证实这些发现。这些潜在益处的潜在机制需要进一步阐明。尽管有局限性,本分析强调了SGLT2i在这一高危人群中作为心脏保护策略的有前景的作用.
