Efficacy and safety of dapagliflozin combined with sacubitril valsartan in the treatment of heart failure after acute myocardial infarction:a Meta-analysis
10.12173/j.issn.1005-0698.202407056
- VernacularTitle:达格列净联合沙库巴曲缬沙坦治疗急性心肌梗死后心力衰竭疗效及安全性的Meta分析
- Author:
Longfei BI
1
;
Yao LIU
;
Bingxia LIU
;
Kui LI
Author Information
1. 成都中医药大学医学与生命科学学院(成都 610075)
- Keywords:
Dapgliflozin;
Sacubitril valsartan;
Myocardial infarction;
Heart failure;
Meta-analysis;
Systematic review;
Randomized controlled trial
- From:
Chinese Journal of Pharmacoepidemiology
2024;33(11):1254-1264
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the efficacy and safety of dapagliflozin combined with sacubitril valsartan in the treatment of heart failure after acute myocardial infarction.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on dapagliflozin combined with sacubitril valsartan(combination treatment group)vs.sacubitril valsartan(monotherapy group)for the treatment of heart failure after acute myocardial infarction from inception to June 18,2024.Two reviewers independently screened the literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was performed using RevMan 5.4 software.Results A total of 11 RCTs involving 1 060 patients were included.Meta-analysis results showed that compared with the monotherapy group,the efficiency of clinical treatment(OR=5.08,95％CI 2.81 to 9.16,P＜0.001),left ventricular ejection fraction(MD=5.02,95％CI 4.08 to 5.95,P＜0.001),6-minute walking distance(MD=56.45,95％CI 32.83 to 80.07,P＜0.001)significantly increased in the combination treatment group,and the levels of N-terminal brain natriuretic peptide precursor(MD=-249.28,95％CI-414.78 to-83.78,P=0.003)and the incidence of major adverse cardiovascular events(OR=0.24,95％CI 0.15 to 0.41,P＜0.001)significantly decreased in the combination treatment group.However,there was no statistically significant difference between the two groups in terms of reducing the incidence of adverse effects(OR=0.66,95％CI 0.31 to 1.38,P=0.27).Conclusion Current evidence shows that the use of the combination of dapagliflozin and sacubitril valsartan for heart failure after acute myocardial infarction is more effective clinically and does not increase the incidence of adverse drug reactions compared with the treatment of sacubitril valsartan alone.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.
