Efficacy of Empagliflozin Therapy in Patient with Acute Heart Failure: Meta-analysis
DOI:
10.29303/jppipa.v9i10.5000Published:
2023-10-25Downloads
Abstract
Heart failure is still a common disorder with a high morbidity and mortality rate around the world. New drugs sodium-glucose cotransporter 2 inhibitors (SGLT2i) such as empagliflozin are currently showing promising results across the HF spectrum. Based on this, the authors are interested in researching the efficacy of Empaglifozin Therapy in Patient with Acute Heart Failure. This study used a systematic search using PRISMA principle in several online databases (Pubmed, Cochrane library and Google scholar). The selected study was an RCT or clinical trial with a population of Acute HF patients. The intervention group is Empagliflozin in any dose compared to placebo. The primary outcome for this meta-analysis is the levels of BNP or NT-proBNP and mortality after intervention. Selected study will be assessed and analyzed using Review Manager software version 5.3 with 95% CI. The two studies selected in this meta-analysis had a total sample size of 290 in the intervention group and 285 in the placebo group. Heterogenecity test obtained [p=0.44; I2 0%], indicating the homogenous data and the study is recommended to use the fixed effect method. The pooled effect size of RR is 0.472 [CI95% 0.24-0.75, P=0.003], meaning that there is a significant favorable outcome in empagliflozin group than in the placebo group. The results showed that empagliflozin had shown a favorable effect in reduction of the risk of death and reducing level of NT-proBNP in patient with acute heart failure.
Keywords:
Empaglifozin Acute Heart Failure NT-proBNP MortalityReferences
Ahmad, M., Daniel, B., Sarosh, V., & Lovely, C. (2022). Congestive heart failure. Nursing Times, 58, 1220–1222.
Arya, S., Kaji, A. H., & Boermeester, M. A. (2021). PRISMA Reporting Guidelines for Meta-analyses and Systematic Reviews. JAMA Surgery, 156(8), 789–790. https://doi.org/10.1001/jamasurg.2021.0546
Bhatt, D. L., Szarek, M., Steg, P. G., Cannon, C. P., Leiter, L. A., McGuire, D. K., … Pitt, B. (2021). Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure. New England Journal of Medicine, 384(2), 117–128. https://doi.org/10.1056/nejmoa2030183
Cherian, T. S., Shrader, P., Fonarow, G. C., Allen, L. A., Piccini, J. P., Peterson, E. D., … Mahaffey, K. W. (2017). Effect of Atrial Fibrillation on Mortality, Stroke Risk, and Quality-of-Life Scores in Patients With Heart Failure (from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation [ORBIT-AF]). American Journal of Cardiology, 119(11), 1763–1769. https://doi.org/10.1016/j.amjcard.2017.02.050
Greenberg, B. H. (2017). Heart failure epidemic. Current Cardiology Reports, 4(3), 185. https://doi.org/10.1007/s11886-002-0048-y
Hummel, A., Empen, K., Dörr, M., & Felix, S. B. (2015). Acute and acutely decompensated chronic heart failure. Deutsches Arzteblatt International, 112(17), 298–310. https://doi.org/10.3238/arztebl.2015.0298
Kato, E. T., Silverman, M. G., Mosenzon, O., Zelniker, T. A., Cahn, A., Furtado, R. H. M., … Wiviott, S. D. (2019). Effect of Dapagliflozin on Heart Failure and Mortality in Type 2 Diabetes Mellitus. Circulation, 139(22), 2528–2536. https://doi.org/10.1161/CIRCULATIONAHA.119.040130
Moellmann, J., Klinkhammer, B. M., Droste, P., Kappel, B., Haj-Yehia, E., Maxeiner, S., … Lehrke, M. (2020). Empagliflozin improves left ventricular diastolic function of db/db mice. Biochimica et Biophysica Acta - Molecular Basis of Disease, 1866(8), 165807. https://doi.org/10.1016/j.bbadis.2020.165807
Mordi, N. A., Mordi, I. R., Singh, J. S., Baig, F., Choy, A. M., McCrimmon, R. J., … Lang, C. C. (2017). Renal and Cardiovascular Effects of sodium-glucose cotransporter 2 (SGLT2) inhibition in combination with loop Diuretics in diabetic patients with Chronic Heart Failure (RECEDE-CHF): Protocol for a randomised controlled double-blind cross-over trial. BMJ Open, 7(10). https://doi.org/10.1136/bmjopen-2017-018097
Nassif, M. E., Windsor, S., Tang, F., Khariton, Y., Husain, M., Inzucchi, S., … Cox, J. (2019). Dapagliflozin effects on biomarkers, symptoms, and functional status in patients with heart failure with reduced ejection fraction. Circulation, 140(18), 1–14. https://doi.org/10.1161/CIRCULATIONAHA.119.042929
Packer, M., Anker, S. D., Butler, J., Filippatos, G., Pocock, S. J., Carson, P., … Zannad, F. (2020). Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. New England Journal of Medicine, 383(15), 1413–1424. https://doi.org/10.1056/nejmoa2022190
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., … Davies, C. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37(27), 2129-2200m. https://doi.org/10.1093/eurheartj/ehw128
Santos-Gallego, C. G., Vargas-Delgado, A. P., Requena-Ibanez, J. A., Garcia-Ropero, A., Mancini, D., Pinney, S., … Badimon, J. J. (2021). Randomized Trial of Empagliflozin in Nondiabetic Patients With Heart Failure and Reduced Ejection Fraction. Journal of the American College of Cardiology, 77(3), 243–255. https://doi.org/10.1016/j.jacc.2020.11.008
Steiner, S. (2016). Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. Zeitschrift Fur Gefassmedizin, 13(1), 17–18. https://doi.org/10.1056/nejmoa1504720
Suzanne L. Topalian, M.D., F. Stephen Hodi, M.D., Julie R. Brahmer, M. D. (2019). Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. New England Journal of Medicine, 365, 687–696. https://doi.org/10.1056/NEJMoa1911303
License
Copyright (c) 2023 Yusra Pintaningrum, Komang Pranayoga
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with Jurnal Penelitian Pendidikan IPA, agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License (CC-BY License). This license allows authors to use all articles, data sets, graphics, and appendices in data mining applications, search engines, web sites, blogs, and other platforms by providing an appropriate reference. The journal allows the author(s) to hold the copyright without restrictions and will retain publishing rights without restrictions.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Jurnal Penelitian Pendidikan IPA.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
