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| Meta-analysis and trial sequential analysis of the effects of SGLT2 inhibitors on cardiovascular adverse events in type 2 diabetes mellitus patients with cardiovascular disease#br# |
| ZHOU Xinrong1 LI Yan1 ZHU Jiajun1 WANG Ning2▲ |
1.Cardiovascular Center Intensive Care Unit, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830054, China;
2.Department of General Second Internal Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830054, China |
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Abstract Objective To evaluate the effects of sodium-glucose linked transporter 2 (SGLT2) inhibitors on cardiovascular adverse events in type 2 diabetes mellitus patients with cardiovascular disease. Methods PubMed, Cochrane Library, Google Scholar, Wanfang Data, CNKI, and Chinese Biomedical Database were searched for randomized controlled trial (RCT) on the effects of SGLT2 inhibitors on cardiovascular adverse events in type 2 diabetes mellitus patients with cardiovascular disease. The retrieval period is from the inception to April 2021. Meta-analysis, sequential analysis, and evidence quality evaluation were performed by RevMan, TSA, and GRADE pro, respectively. Results Six RCTs were included, with a total of 30 534 patients. Meta-analysis showed that cardiovascular mortality rate (RR = 0.84, 95%CI: 0.72-0.99, P = 0.03), hospitalization rate for heart failure (RR = 0.67, 95%CI: 0.60-0.73, P ＜ 0.000 01), and all-cause mortality (RR = 0.85, 95%CI: 0.78-0.92, P ＜ 0.0001) were lower than those in placebo group. GRADE evidence quality evaluation results showed that the quality GRADE of meta-analysis results was “high”. The sequential analysis results showed that the meta-analysis results were relatively positive and did not need to be proved by more experiments. Conclusion SGLT2 inhibitors plays a good cardioprotective role in type 2 diabetes mellitus patients with cardiovascular disease.
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[1] 杨秀颖，张莉，陈熙，等.2型糖尿病周围神经病变机制研究进展[J].中国药理学通报，2016，32（5）：598-602.DOI：10.3969/j.issn.1001-1978.2016.05.002.
[2] Al-Jarallah M，Rajan R，Al-Zakwani I，et al. Impact of diabetes on mortality and rehospitalization in acute heart failure patients stratified by ejection fraction [J]. ESC Heart Fail，2020，7（1）：297-305. DOI：10.1002/ehf2.12538.
[3] 陈楠，韩睿，张建伟，等.钠-葡萄糖协同转运蛋白2抑制剂的临床应用研究进展[J].中国糖尿病杂志，2019，27（4）：312-315. DOI：10.3969/j.issn.1006-6187.2019.04.015.
[4] 缪洪芸，李斌.治疗2型糖尿病新药：钠-葡萄糖协同转运蛋白2抑制剂[J].重庆医学，2016，45（15）：2139-2142. DOI：10.3969/j.issn.1671-8348.2016.15.037.
[5] 王康丽，洪天配，魏蕊.SGLT2抑制剂对胰岛β细胞的保护作用及潜在机制[J].中华内分泌代谢杂志，2021，37（4）：297-300. DOI：10.3760/cma.j.cn311282-20200814-00577.
[6] Higgins J，Green SR. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [M]. The Cochrane Collaboration：2011.
[7] Kulinskaya E，Wood J. Trial sequential methods for meta-analysis [J]. Res Synth Methods，2014，5（3）：212-220. DOI：10.1002/jrsm.1104.
[8] 陈耀龙，杨克虎，姚亮，等.GRADE系统方法学进展[J].中国循证儿科杂志，2013，8（1）：64-65. DOI：10.3969/j.issn.1673-5501.2013.01.014.
[9] Bhatt DL，Szarek M，Steg PG，et al. Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure [J]. N Engl J Med，2021，384（2）：117-128. DOI：10.1056/NEJMoa2030183.
[10] Cannon CP，Pratley R，Dagogo-Jack S，et al. Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes [J]. N Engl J Med，2020，383（15）：1425-1435. DOI：10.1056/NEJMoa2004967.
[11] Furtado RHM，Bonaca MP，Raz I，et al. Dapagliflozin and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus and Previous Myocardial Infarction [J]. Circulation，2019，139（22）：2516-2527. DOI：10.1161/CIRCULATIONAHA.119.039996.
[12] Kosiborod M，Gause-Nilsson I，Xu J，et al. Efficacy and safety of dapagliflozin in patients with type 2 diabetes and concomitant heart failure [J]. J Diabetes Complications，2017，31（7）：1215-1221. DOI：10.1016/j.jdiacomp.2017.02.001.
[13] Neal B，Perkovic V，Matthews DR. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes [J]. N Engl J Med，2017，377（7）：644-657. DOI：10.1056/NEJMc1712572.
[14] Zinman B，Wanner C，Lachin JM，et al. Empagliflozin，Cardiovascular Outcomes，and Mortality in Type 2 Diabetes [J]. N Engl J Med，2015，373（22）：2117-2128. DOI： 10.1056/NEJMoa1504720.
[15] 崔景秋.糖尿病心血管病变[J].中华医学信息导报，2009， 24（10）：19-20.
[16] 黄敬泽，王健，张闿珍，等.血管内皮细胞损伤在2型糖尿病血管病变中的意义[J].中华内分泌代谢杂志，2000， 16（3）：169-171. DOI：10.3760/j.issn：1000-6699.2000. 03.010.
[17] 苏海燕，潘长玉.糖代谢异常与心血管疾病关系的再认识[J].中国实用内科杂志，2007，27（22）：1799-1801. DOI：10.3969/j.issn.1005-2194.2007.22.024.
[18] Scirica BM，Bhatt DL，Braunwald E，et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus [J]. N Engl J Med，2013，369（14）：1317-1326. DOI：10.1056/NEJMoa1307684.
[19] Wiviott SD，Raz I，Bonaca MP，et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes [J]. N Engl J Med，2019，380（4）：347-357. DOI：10.1056/NEJMoa 1812389.
[20] 张琦，刘静.SGLT2抑制剂的心脏保护作用[J].中国实用内科杂志，2020，40（8）：630-633. DOI：10.19538/j.nk2020080104.
[21] 刘雪凤，谭丽艳，徐洋海.SGLT-2抑制剂对2型糖尿病大血管保护作用的研究进展[J].中国医药科学，2021， 11（20）：4. DOI：10.3969/j.issn.2095-0616.2021.20.019.
[22] 王权，田金徽，李伦，等.试验序贯分析简介[J].中国循证医学杂志，2013，13（10）：1265-1268. DOI：10.7507/1672-2531.20130216.
[23] 翁鸿，李胜，曾宪涛，等.试验序贯分析软件在Meta分析中的应用[J].中国循证医学杂志，2016，16（5）：604-611. DOI：10.7507/1672-2531.20160093.
[24] 朱蕾，杨怡.钠-葡萄糖协同转运蛋白与糖尿病[J].国际内分泌代谢杂志，2011，31（6）：406-408. DOI：10.3760/cma.j.issn.1673-4157.2011.06.014.
[25] 边南南，曲爱娟，王广.钠-葡萄糖共转运蛋白2抑制剂心血管保护机制进展[J].中华糖尿病杂志，2020，12（11）：938-941. DOI：10.3760/cma.j.cn115791-20200417-00225.
[26] 张可心，李玉子.钠-葡萄糖协同转运蛋白2抑制剂相关心血管获益的潜在机制[J].中国老年学杂志，2021， 41（10）：2212-2216. DOI：10.3969/j.issn.1005-9202.2021. 10.055. |
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