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Meta-Analysis
. 2023 Aug 22;18(1):45.
doi: 10.5334/gh.1258. eCollection 2023.

Effect of Dapagliflozin in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Ahmed E Ali  1   2 , Muhammad Sabry Mazroua  2   3 , Mariam ElSaban  2   4 , Nadia Najam  2   5 , Aditi S Kothari  2   6 , Taha Mansoor  2   7 , Tanya Amal  2   8 , Joanna Lee  2   9 , Rahul Kashyap  2   10   11
Affiliations
Meta-Analysis

Effect of Dapagliflozin in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Ahmed E Ali et al. Glob Heart. .

Abstract

Background: Heart failure (HF) is a major cause of recurrent hospitalization and death worldwide. Sodium-glucose cotransporter-2 inhibitors including dapagliflozin are anti-diabetic drugs with promising cardiovascular (CV) effects. We performed systematic review and meta-analysis of randomized controlled trials investigating the effects of dapagliflozin in heart failure patients.

Methods: We searched PubMed, Scopus and ScienceDirect databases. A total of 1,567 studies from January 2017 to September 10, 2022, were screened. After applying exclusion criteria, 22 studies were retrieved for full-text screening, and nine of them were eligible for this meta-analysis. Effect estimates for dichotomous variables were expressed as risk ratio (RR) and 95% CI. The primary outcomes were the incidence of all-cause mortality, hospitalization due to HF, and CV death. This review was registered on PROSPERO with ID CRD42022347793.

Results: A total of 14,032 patients were included. The overall risk ratio of all-cause mortality favored the dapagliflozin group over the placebo/standard therapy group (RR = 0.89, 95% CI: 0.82-0.97, P = 0.006) and the pooled studies were not heterogenous (I2 = 0%). Additionally, dapagliflozin significantly reduced the hospitalization due to heart failure (RR = 0.76, 95% CI: 0.70-0.84, P > 0.00001, I2 = 0%), cardiovascular death (RR = 0.87, 95% CI: 0.78-0.97, P = 0.01, I2 = 0%) and their composite outcomes.

Conclusion: Dapagliflozin reduces the risk of all-cause mortality, heart failure hospitalizations and cardiovascular death in a wide range of heart failure patients.

Keywords: Dapagliflozin; Diabetes Mellitus; Forxiga; Heart failure; SGLT2-inhibitors.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare.

Figures

Chart showing the included studies about dapagliflozin in heart failure
Figure 1
PRISMA Flow Chart of Dapagliflozin in Patients with Heart Failure.
Graph showing the risk of bias in the included studies
Figure 2
Risk of Bias Graph.
Plot showing the effects of dapagliflozin on heart failure patients
Figure 3
Forest Plot of A) All-Cause Mortality. B) Heart Failure Hospitalizations. C) Cardiovascular Deaths. D) Cardiovascular Deaths or Heart Failure Hospitalizations.
Plot showing the effects of dapagliflozin on heart failure patients
Figure 4
Forest Plot of A) Urgent Heart Failure Visits. B) Heart Failure Hospitalization or Urgent Heart Failure Visit. C) Worsening Heart Failure Event (hospitalization or urgent visit) or Cardiovascular Death.
Effects of dapagliflozin in heart failure with reduced ejection fraction
Figure 5
HFrEF Subgroup Forest Plots of A) All-Cause Mortality. B) Cardiovascular Deaths. C) Heart Failure Hospitalizations. D) Heart Failure hospitalization or Urgent Heart Failure Visit.
Effects of dapagliflozin in heart failure with preserved ejection fraction
Figure 6
HFpEF Subgroup Forest Plots of A) All-Cause Mortality. B) Heart Failure Hospitalization or Urgent Heart Failure Visit.
See this image and copyright information in PMC

References

    1. Metra M, Carubelli V, Ravera A, Stewart Coats AJ. Heart failure 2016: still more questions than answers. International Journal of Cardiology. 2016; 227: 766–777. DOI: 10.1016/j.ijcard.2016.10.060 - DOI - PubMed
    1. Mentz RJ, Kelly JP, von Lueder TG, Voors AA, Lam CS, Cowie MR, et al. Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction. Journal of the American College of Cardiology. 2014; 64(21): 2281–2293. DOI: 10.1016/j.jacc.2014.08.036 - DOI - PMC - PubMed
    1. Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: the Framingham study. The American Journal of Cardiology. 1974; 34(1): 29–34. DOI: 10.1016/0002-9149(74)90089-7 - DOI - PubMed
    1. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. The New England Journal of Medicine. 2015; 373(22): 2117–2128. DOI: 10.1056/NEJMoa1504720 - DOI - PubMed
    1. Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. The New England Journal of Medicine. 2017; 377(7): 644–657. DOI: 10.1056/NEJMoa1611925 - DOI - PubMed

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