Please use this identifier to cite or link to this item:
https://doi.org/10.1002/ehf2.13822
DC Field | Value | |
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dc.title | Can glucose-lowering medications improve outcomes in non-diabetic heart failure patients? A Bayesian network meta-analysis | |
dc.contributor.author | Yeong, Trevor | |
dc.contributor.author | Mai, Aaron Shengting | |
dc.contributor.author | Lim, Oliver ZH | |
dc.contributor.author | Ng, Cheng Han | |
dc.contributor.author | Chin, Yip Han | |
dc.contributor.author | Tay, Phoebe | |
dc.contributor.author | Lin, Chaoxing | |
dc.contributor.author | Muthiah, Mark | |
dc.contributor.author | Khoo, Chin Meng | |
dc.contributor.author | Dalakoti, Mayank | |
dc.contributor.author | Loh, Poay-Huan | |
dc.contributor.author | Chan, Mark | |
dc.contributor.author | Yeo, Tiong-Cheng | |
dc.contributor.author | Foo, Roger | |
dc.contributor.author | Wong, Raymond | |
dc.contributor.author | Chew, Nicholas WS | |
dc.contributor.author | Lin, Weiqin | |
dc.date.accessioned | 2022-04-21T01:13:50Z | |
dc.date.available | 2022-04-21T01:13:50Z | |
dc.date.issued | 2022-01-29 | |
dc.identifier.citation | Yeong, Trevor, Mai, Aaron Shengting, Lim, Oliver ZH, Ng, Cheng Han, Chin, Yip Han, Tay, Phoebe, Lin, Chaoxing, Muthiah, Mark, Khoo, Chin Meng, Dalakoti, Mayank, Loh, Poay-Huan, Chan, Mark, Yeo, Tiong-Cheng, Foo, Roger, Wong, Raymond, Chew, Nicholas WS, Lin, Weiqin (2022-01-29). Can glucose-lowering medications improve outcomes in non-diabetic heart failure patients? A Bayesian network meta-analysis. ESC HEART FAILURE 9 (2) : 1338-1350. ScholarBank@NUS Repository. https://doi.org/10.1002/ehf2.13822 | |
dc.identifier.issn | 2055-5822 | |
dc.identifier.issn | 2055-5822 | |
dc.identifier.uri | https://scholarbank.nus.edu.sg/handle/10635/219418 | |
dc.description.abstract | Aims: The cardioprotective effects of glucose-lowering medications in diabetic patients with heart failure (HF) are well known. Several large randomized controlled trials (RCTs) have recently suggested that the cardioprotective effects of glucose-lowering medications extend to HF patients regardless of diabetic status. The aim of this study was to conduct a Bayesian network meta-analysis to evaluate the impact of various glucose-lowering medications on the outcomes of non-diabetic HF patients. Methods and results: Medline and Embase were searched for RCTs investigating the use of glucose-lowering medications in non-diabetic HF patients in August 2021. Studies were included in accordance with the inclusion and exclusion criteria, and data were extracted with a pre-defined datasheet. Primary outcomes include serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels, left ventricular ejection fraction (LVEF), and maximal oxygen consumption (PVO2). A Bayesian network meta-analysis was performed to compare the effectiveness of different classes of glucose-lowering medications in improving HF outcomes. Risk-of-bias was assessed using Cochrane Risk-of-Bias tool 2.0 for randomized trials (ROB2). Seven RCTs involving 2897 patients were included. Sodium-glucose transporter 2 inhibitor (SGLT2i) was the most favourable in lowering NT-proBNP, with the significant reduction in NT-proBNP when compared with glucagon-like peptide-1 receptor agonists (GLP1-RA) [mean differences (MD): −229.59 pg/mL, 95%-credible intervals (95%-CrI): −238.31 to −220.91], metformin (MD: −237.15 pg/mL, 95%-CrI: −256.19 to −218.14), and placebo (MD: −228.00 pg/mL, 95%-CrI: −233.99 to −221.99). SGLT2i was more effective in improving LVEF for HF with reduced ejection fraction patients relative to GLP1-RA (MD: 8.09%, 95%-CrI: 6.30 to 9.88) and placebo (MD: 6.10%, 95%-CrI: 4.37 to 7.84). SGLT2i and GLP1-RA were more favourable to placebo in improving PVO2, with significant increase of PVO2 at a MD of 1.60 mL/kg/min (95%-CrI: 0.63 to 2.57) and 0.86 mL/kg/min (95%-CrI: 0.66 to 1.06), respectively. All three drugs had comparable safety profiles when compared with placebo. Conclusions: This Bayesian network meta-analysis demonstrated that SGLT2i, when compared with GLP1-RA and metformin, was superior in improving LVEF in HF with reduced ejection fraction patients, as well as improving PVO2 and NT-proBNP in non-diabetic HF patients. Further large-scale prospective studies are needed to confirm these preliminary findings. | |
dc.language.iso | en | |
dc.publisher | WILEY PERIODICALS, INC | |
dc.source | Elements | |
dc.subject | Science & Technology | |
dc.subject | Life Sciences & Biomedicine | |
dc.subject | Cardiac & Cardiovascular Systems | |
dc.subject | Cardiovascular System & Cardiology | |
dc.subject | Heart failure | |
dc.subject | Sodium-glucose cotransporter 2 inhibitors | |
dc.subject | Glucagon-like peptide 1 receptor agonists | |
dc.subject | Metformin | |
dc.subject | GLP-1 RECEPTOR AGONISTS | |
dc.subject | CARDIOVASCULAR OUTCOMES | |
dc.subject | EJECTION FRACTION | |
dc.subject | SGLT2 INHIBITORS | |
dc.subject | MORTALITY | |
dc.subject | LIRAGLUTIDE | |
dc.subject | EMPAGLIFLOZIN | |
dc.subject | HOSPITALIZATION | |
dc.subject | DISEASE | |
dc.subject | DEATH | |
dc.type | Article | |
dc.date.updated | 2022-04-20T13:57:37Z | |
dc.contributor.department | MEDICINE | |
dc.description.doi | 10.1002/ehf2.13822 | |
dc.description.sourcetitle | ESC HEART FAILURE | |
dc.description.volume | 9 | |
dc.description.issue | 2 | |
dc.description.page | 1338-1350 | |
dc.published.state | Published | |
Appears in Collections: | Staff Publications Elements |
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