Please use this identifier to cite or link to this item: https://doi.org/10.1002/ehf2.13822
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dc.titleCan glucose-lowering medications improve outcomes in non-diabetic heart failure patients? A Bayesian network meta-analysis
dc.contributor.authorYeong, Trevor
dc.contributor.authorMai, Aaron Shengting
dc.contributor.authorLim, Oliver ZH
dc.contributor.authorNg, Cheng Han
dc.contributor.authorChin, Yip Han
dc.contributor.authorTay, Phoebe
dc.contributor.authorLin, Chaoxing
dc.contributor.authorMuthiah, Mark
dc.contributor.authorKhoo, Chin Meng
dc.contributor.authorDalakoti, Mayank
dc.contributor.authorLoh, Poay-Huan
dc.contributor.authorChan, Mark
dc.contributor.authorYeo, Tiong-Cheng
dc.contributor.authorFoo, Roger
dc.contributor.authorWong, Raymond
dc.contributor.authorChew, Nicholas WS
dc.contributor.authorLin, Weiqin
dc.date.accessioned2022-04-21T01:13:50Z
dc.date.available2022-04-21T01:13:50Z
dc.date.issued2022-01-29
dc.identifier.citationYeong, 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.issn2055-5822
dc.identifier.issn2055-5822
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/219418
dc.description.abstractAims: 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.isoen
dc.publisherWILEY PERIODICALS, INC
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectCardiac & Cardiovascular Systems
dc.subjectCardiovascular System & Cardiology
dc.subjectHeart failure
dc.subjectSodium-glucose cotransporter 2 inhibitors
dc.subjectGlucagon-like peptide 1 receptor agonists
dc.subjectMetformin
dc.subjectGLP-1 RECEPTOR AGONISTS
dc.subjectCARDIOVASCULAR OUTCOMES
dc.subjectEJECTION FRACTION
dc.subjectSGLT2 INHIBITORS
dc.subjectMORTALITY
dc.subjectLIRAGLUTIDE
dc.subjectEMPAGLIFLOZIN
dc.subjectHOSPITALIZATION
dc.subjectDISEASE
dc.subjectDEATH
dc.typeArticle
dc.date.updated2022-04-20T13:57:37Z
dc.contributor.departmentMEDICINE
dc.description.doi10.1002/ehf2.13822
dc.description.sourcetitleESC HEART FAILURE
dc.description.volume9
dc.description.issue2
dc.description.page1338-1350
dc.published.statePublished
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