SGLT2 inhibitors reduce sudden cardiac death risk in heart failure: Meta-analysis of randomized clinical trials.

MedStar author(s):
Citation: Journal of Cardiovascular Electrophysiology. 34(5):1277-1285, 2023 May.PMID: 36950852Institution: MedStar Washington Hospital CenterDepartment: Cardiovascular Disease FellowshipForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Atrial Fibrillation | *Diabetes Mellitus, Type 2 | *Heart Failure | *Sodium-Glucose Transporter 2 Inhibitors | Atrial Fibrillation/co [Complications] | Death, Sudden, Cardiac/ep [Epidemiology] | Death, Sudden, Cardiac/et [Etiology] | Death, Sudden, Cardiac/pc [Prevention & Control] | Heart Failure/co [Complications] | Heart Failure/di [Diagnosis] | Heart Failure/dt [Drug Therapy] | Humans | Prospective Studies | Randomized Controlled Trials as Topic | Sodium-Glucose Transporter 2 Inhibitors/ae [Adverse Effects] | Year: 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: 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. Copyright © 2023 Wiley Periodicals LLC.INTRODUCTION: 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.METHODS: A comprehensive search was performed to identify relevant data published before 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 (sudden cardiac death [SCD], ventricular arrhythmias, atrial arrhythmias).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 (risk ratios [RR]: 0.68; 95% confidence intervals [CI]: 0.48-0.95; p = .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 = .77; I2 = 0%) or atrial arrhythmias (RR: 0.91; 95% CI: 0.77-1.09; p = .31; I2 = 29%) between patients receiving an SGLT2i versus placebo.All authors: Basyal B, Dukkipati SR, Kawamura I, Koruth JS, Miller MA, Moss N, Musikantow DR, Oates CP, Reddy VY, Santos-Gallego CG, Smith A, Turagam MK, Whang WFiscal year: FY2023Digital Object Identifier: Date added to catalog: 06/01/2023
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 36950852 Available 36950852

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

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. Copyright © 2023 Wiley Periodicals LLC.

INTRODUCTION: 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.

METHODS: A comprehensive search was performed to identify relevant data published before 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 (sudden cardiac death [SCD], ventricular arrhythmias, atrial arrhythmias).

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 (risk ratios [RR]: 0.68; 95% confidence intervals [CI]: 0.48-0.95; p = .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 = .77; I2 = 0%) or atrial arrhythmias (RR: 0.91; 95% CI: 0.77-1.09; p = .31; I2 = 29%) between patients receiving an SGLT2i versus placebo.

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