| Objective: To clear SGLT-2 inhibitors’ effect on heart failure’s cardiovascular prognosis and cardiac function indexes,and to appraise SGLT-2 inhibitors’ effects on different heart failure types.Methods: A computer was exploited to retrieve the most commonly used databases including Pub Med,Medline,Web of Science,Cochrane Library,CNKI,Wan Fang and VIP.The retrieval date started from databases establishment time,ended at December4,2020.Literatures involving treatment effect of SGLT-2 inhibitors on chronic heart failure contains cardiac function indexes change NT-pro BNP,KCCQ,6-minute walking distance and cardiovascular prognosis outcomes,writed in Chinese or English,were collected.Screening,quality evaluation and data extraction were performed by two researchers independently.With regard to combination and analysis of data,Review Manage 5.3 software was used.Result: A total of 13 medium and high-quality articles were included in this study,including 13,659 subjects,6995 subjects in the trial group and 6664 subjects in the control /placebo group.Meta-analysis results of fixed effects model showed that chronic heart failure patients’ change of NT-pro BNP in the SGLT-2 inhibitor group was much lower [SMD=-0.11,95%CI(-0.16,-0.06),P<0.01] compared with placebo group,6-minute walking distance [SMD=1.33,95%CI(1.10,1.56),P<0.01]、risk about death from cardiovascular causes [HR= 0.79,95%CI(0.68,0.92),P<0.05],heart failure hospitalization [HR= 0.85,95%CI(0.81,0.90),P<0.01],heart failure hospitalization or cardiovascular death combined events [HR= 0.87,95%CI(0.84,0.91),P<0.01],death from any cause [HR= 0.93,95%CI(0.89,0.98),P<0.05],major adverse events [HR=0.95,95%CI(0.92,0.98),P<0.05] in the SGLT-2 inhibitor group were lower than those in the placebo group,the differences were statistically significant.NT-pro BNP levels was significantly reduced by SGLT-2 inhibitors compared with placebo for heart failure with reduced ejection fraction [SMD=-0.11,95%CI(-0.16,-0.06),P<0.01],the difference was statistically significant.For heart failure with reduced ejection fraction with or without type 2 diabetes patients,hospitalization for heart failure or death from cardiovascular causes risk was significantly lower in the SGLT-2 inhibitor group than in the placebo group [HR= 0.88,95%CI(0.83,0.93),P<0.01],and the differences were statistically significant.Conclusion: SGLT-2 inhibitors are associated with reduced NT-Pro BNP,improved 6-minute walking distance,and cardiovascular outcomes in patients with chronic heart failure.For patients with reduced ejection fraction heart failure,SGLT-2inhibitors have been associated with reduced NT-Pro BNP levels,and reduced the risk of cardiovascular death or heart failure hospitalization in patients with or without coexisting type 2 diabetes. |
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