SGLT2 Inhibitors Reduce Sudden Cardiac Death Risk in Heart Failure: Meta-analysis of Randomized Clinical Trials.

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Citation: Journal of Cardiovascular Electrophysiology. 2023 Mar 23PMID: 36950852Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Cardiovascular Disease FellowshipForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2023Local holdings: Available online through MWHC library: 2007 -2010, Available in print through MWHC library: 1999 - 2006ISSN:
  • 1045-3873
Name of journal: Journal of cardiovascular electrophysiologyAbstract: BACKGROUND: Multiple randomized controlled trials have demonstrated sodium-glucose cotransporter-2 inhibitors (SGLT2i) decrease the composite endpoint of cardiovascular death or heart failure hospitalizations in all heart failure patients. It is uncertain whether SGLT2i impacts the risk of sudden cardiac death in patients with heart failure.CONCLUSION: SGLT2i therapy is associated with a reduced risk of SCD in patients with heart failure receiving contemporary medical therapy. Prospective trials are needed to determine the long-term impact of SGLT2i therapy on atrial and ventricular arrhythmias. This article is protected by copyright. All rights reserved. Copyright This article is protected by copyright. All rights reserved.METHODS: A comprehensive search was performed to identify relevant data published prior to August 28, 2022. Trials were included if: 1) all patients had clinical heart failure 2) SGLT2i and placebo were compared 3) all patients received conventional medical therapy and 4) reported outcomes of interest (SCD, ventricular arrhythmias, atrial arrhythmias).OBJECTIVE: To assess the impact of SGLT2i therapy on arrhythmic outcomes in patients with heart failure receiving optimal medical therapy.RESULTS: SCD was reported in seven of the eleven trials meeting selection criteria: 10,796 patients received SGLT2i and 10,796 received placebo. SGLT2i therapy was associated with a significant reduction in the risk of SCD (RR 0.68; 95% CI 0.48-0.95; p = 0.03; I2 = 0%). Absent dedicated rhythm monitoring, there were no significant differences in the incidence of sustained ventricular arrhythmias not associated with SCD (RR 1.03; 95% CI, 0.83-1.29; p = 0.77; I2 = 0%) or atrial arrhythmias (RR 0.91; 95% CI, 0.77-1.09; p = 0.31; I2 = 29%) between patients receiving an SGLT2i vs placebo.All authors: Oates CP, Santos-Gallego CG, Smith A, Basyal B, Moss N, Kawamura I, Musikantow DR, Turagam MK, Miller MA, Whang W, Dukkipati SR, Reddy VY, Koruth JSFiscal year: FY2023Digital Object Identifier: Date added to catalog: 2023-04-11
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Journal Article MedStar Authors Catalog Article Available

Available online through MWHC library: 2007 -2010, Available in print through MWHC library: 1999 - 2006

BACKGROUND: Multiple randomized controlled trials have demonstrated sodium-glucose cotransporter-2 inhibitors (SGLT2i) decrease the composite endpoint of cardiovascular death or heart failure hospitalizations in all heart failure patients. It is uncertain whether SGLT2i impacts the risk of sudden cardiac death in patients with heart failure.

CONCLUSION: SGLT2i therapy is associated with a reduced risk of SCD in patients with heart failure receiving contemporary medical therapy. Prospective trials are needed to determine the long-term impact of SGLT2i therapy on atrial and ventricular arrhythmias. This article is protected by copyright. All rights reserved. Copyright This article is protected by copyright. All rights reserved.

METHODS: A comprehensive search was performed to identify relevant data published prior to August 28, 2022. Trials were included if: 1) all patients had clinical heart failure 2) SGLT2i and placebo were compared 3) all patients received conventional medical therapy and 4) reported outcomes of interest (SCD, ventricular arrhythmias, atrial arrhythmias).

OBJECTIVE: To assess the impact of SGLT2i therapy on arrhythmic outcomes in patients with heart failure receiving optimal medical therapy.

RESULTS: SCD was reported in seven of the eleven trials meeting selection criteria: 10,796 patients received SGLT2i and 10,796 received placebo. SGLT2i therapy was associated with a significant reduction in the risk of SCD (RR 0.68; 95% CI 0.48-0.95; p = 0.03; I2 = 0%). Absent dedicated rhythm monitoring, there were no significant differences in the incidence of sustained ventricular arrhythmias not associated with SCD (RR 1.03; 95% CI, 0.83-1.29; p = 0.77; I2 = 0%) or atrial arrhythmias (RR 0.91; 95% CI, 0.77-1.09; p = 0.31; I2 = 29%) between patients receiving an SGLT2i vs placebo.

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