Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Dec 25, 2023; 12(5): 182-200
Published online Dec 25, 2023. doi: 10.5527/wjn.v12.i5.182
Heterogeneity in cardiorenal protection by Sodium glucose cotransporter 2 inhibitors in heart failure across the ejection fraction strata: Systematic review and meta-analysis
Saeed Taheri
Saeed Taheri, Department of Medicine, New Lahijan Scientific Foundation, Lahijan 4415813166, Iran
Author contributions: Taheri S performed all the tasks.
Conflict-of-interest statement: No financial support was received by the author. The author has no financial interests on the findings of this study.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Saeed Taheri, MD, Doctor, Department of Medicine, New Lahijan Scientific Foundation, #1 Kargar 19, 2nd ave; Lahijan; Iran , Lahijan 4415813166, Iran. taherimd@gmail.com
Received: May 23, 2023
Peer-review started: May 23, 2023
First decision: August 16, 2023
Revised: September 1, 2023
Accepted: September 25, 2023
Article in press: September 25, 2023
Published online: December 25, 2023
Processing time: 213 Days and 4.4 Hours
ARTICLE HIGHLIGHTS
Research background

Gliflozins have been shown effective to improve outcomes in patients with heart failure.

Research motivation

Finding the indications for the prescription of gliflozins would help to concentrate research on subgroups that need further research and novel therapeutic approach.

Research objectives

To find the subpopulations of heart failure patients that benefit most from Sodium glucose cotransporter 2 (SGLT2) inhibitors based on their left ventricular ejection fraction levels.

Research methods

A systematic review and meta-analysis of data of patients receiving gliflozin thepay in large and robust randomized double-blind placebo trials was conducted. Meta-analyses were conducted after stratification of the patients based on their left ventricular ejection fraction (LVEF) levels.

Research results

Gliflozins were generally superior to placebo in improving composite outcome of patients with heart failure across LVEF levels. This therapeutic effects were more pronounced in patients with reduced LVEF and low New York Heart Associations classes. No survival benefit was detected for patients with preserved ejection fraction disease.

Research conclusions

Gliflozins are effective in improving the outcome in patients with heart failure.

Research perspectives

Further research would be needed to examine the magnitude of gliflozins' efficacy as well as its cost-effectiveness compared to the other therapeutic options in this patient population.