Meta-analysis Of SGLT-2 Inhibitor In The Treatment Of Heart Failure With Preserved Ejection Fraction In Patients With Type 2 Diabetes Mellitus

Objective:To explore the effect of SGLT-2 inhibitor on heart failure with preserved ejection fraction based on type 2 diabetes mellitus.Methods:The database of China How Net,Wanfang Medical Network,Pub Med and Web of science was searched systematically.The retrieval time was from the establishment of the database to February 1,2023,and there was no restriction on the region and sample size.The RCT of SGLT2 inhibitor in the treatment of T2 DM complicated with HFp EF was collected,and both Chinese and English RCT experiments were available.After screening the literature and extracting the data,The Coc HRane bias risk assessment tool was used to evaluate the quality of the included literature,and Review Manager 5.4 software was used to conduct Meta-analysis.Results:A total of 16 items of RCT were included,including 15064 patients with T2 DM complicated with HFp EF.Meta-analysis showed that SGLT-2 inhibitor effectively improved the LVEF(SMD=0.65,95%CI 0.25,1.05,Z=3.18,P=0.001)、LVEDD(SMD=-0.97,95%CI-1.70,-0.23,Z=2.57,P=0.01),NT-pro BNP(SMD=-2.16,95%CI-3.10,-1.21,Z=4.48,P<0.05),Hb A1c(SMD=-0.98,95%CI-1.54,-0.42,Z=3.43,P=0.0006 < 0.05),SBP(SMD=-0.96,95%CI-1.78,-0.14,Z=2.30,P=0.02< 0.05),CRP(SMD=-3.91,95%CI-6.69,-1.12,Z=2.75,P=0.006)and reduced the risk of cardiovascular death and readmission(SMD=-4.52,95%CI-8.16,-0.88,Z=2.43,P=0.01).In terms of related adverse reactions,there was no significant difference in the risk of hypoglycemia,hypovolemia or hypotension and urinary tract infection,and the risk of renal function deterioration was lower than that of the control group(OR=0.79,95%CI0.68,0.92,Z=3.04,P=0.002).The analysis of publication bias shows that there is little possibility of publication bias.Conclusions:SGLT-2 inhibitor has a positive effect on patients with heart failure with preserved ejection fraction based on type 2 diabetes,and there is no significant difference in the risk of hypoglycemia,hypovolemia or hypotension between the experimental group and the control group in terms of related adverse reactions.