SGLT2 Inhibitors Reduce Heart Failure Hospitalization

But no indication of protection against all-cause death, kidney disease progression, or kidney failure; increased risk of genital infection
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TUESDAY, April 12, 2022 (HealthDay News) -- For patients with heart failure, sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce hospitalization for heart failure and cardiovascular death, but increase the risk of genital infections, according to a review published online April 12 in the Annals of Internal Medicine.

Xinyu Zou, from Sichuan University in Chengdu, China, and colleagues examined the effect of SGLT2 inhibitors in people with heart failure in a systematic review of trials in which adults with heart failure were randomly assigned to SGLT2 inhibitors or control, regardless of the presence of type 2 diabetes.

The researchers found that SGLT2 inhibitors reduced hospitalization for heart failure by 37, 32, and 26 percent at six months, one year, and two years, respectively (all high certainty), and yielded a 14 percent reduction in cardiovascular death at one year (high certainty). Based on low certainty evidence, there was no indication of protection against all-cause death, kidney disease progression, or kidney failure. Patients treated in the first year and those with poorer prognoses, such as those with newly diagnosed heart failure in the hospital, have greater anticipated absolute benefits. The risk of genital infections was increased more than twofold with SGLT2 inhibitors (risk ratio, 2.69; high certainty).

"The anticipated absolute benefits of reducing heart failure hospitalizations depend on both baseline risk and treatment duration and should be balanced against the potential harms of increased genital infections," the authors write.

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