Evidence map›Paper›PMID 37917192›Full record

SynthesisHeart failure reviews2024

Adverse effects of sodium-glucose cotransporter-2 inhibitors in patients with heart failure: a systematic review and meta-analysis.

A Pozzi, C Cirelli, A Merlo, F Rea, C Scangiuzzi, E Tavano, A Iorio, S L Kristensen, C Wong, A Iacovoni and 1 more

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Heart failure reviews, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 3 countries.

A PozziCardiology Division, Valduce Hospital, Como, Italy. andreawellsvabg@gmail.com.ORCID 0000-0002-9819-2148
C CirelliCardiology Division, Papa Giovanni XXIII Hospital, Bergamo, Italy.
A MerloCardiology Division, Papa Giovanni XXIII Hospital, Bergamo, Italy.
F ReaDepartment of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
C ScangiuzziCardiology Division, Papa Giovanni XXIII Hospital, Bergamo, Italy.
E TavanoCardiology Division, Circolo Hospital, Busto Arsizio, Italy.
A IorioCardiology Division, Papa Giovanni XXIII Hospital, Bergamo, Italy.
S L KristensenCardiology Division, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark.
C WongCardiology Division, North Bristol, Bristol, UK.
A IacovoniCardiology Division, Papa Giovanni XXIII Hospital, Bergamo, Italy.
G CorradoCardiology Division, Valduce Hospital, Como, Italy.
Ospedale Papa Giovanni XXIII · ITOspedale Valduce · ITCopenhagen University Hospital · DKNorth Bristol NHS Trust · GBOspedale di Circolo di Busto Arsizio · ITUniversity of Milano-Bicocca · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sodium-glucose cotransoporter-2 inhibitors (SGLT-2Is) improve prognosis in heart failure (HF) patients both with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). However, these drugs can have some side effects. To estimate the relative risk of side effects in HF patients treated with SGLT-2Is irrespective from left ventricular EF and setting (chronic and non-chronic HF). Five randomized controlled trials (RCTs) enrolling patients with HFrEF, 4 RCTs enrolling non-chronic HF, and 3 RCTs enrolling HFpEF were included. Among side effects, urinary infection, genital infection, acute kidney injury, diabetic ketoacidosis, hypoglycemia, hyperkalemia, hypokalemia, bone fractures, and amputations were considered in the analysis. Overall, 24,055 patients were included in the analysis: 9020 (38%) patients with HFrEF, 12,562 (52%) with HFpEF, and 2473 (10%) with non-chronic HF. There were no differences between SGLT-2Is and placebo in the risk to develop diabetic ketoacidosis, hypoglycemia, hyperkalemia, hypokalemia, bone fractures, and amputations. HFrEF patients treated with SGLT-2Is had a significant reduction of acute kidney injury (RR = 0.54 (95% CI 0.33-0.87), p = 0.011), whereas no differences have been reported in the HFpEF group (RR = 0.94 (95% CI 0.83-1.07), p = 0.348) and non-chronic HF setting (RR = 0.79 (95% CI 0.55-1.15), p = 0.214). A higher risk to develop genital infection (overall 2.57 (95% CI 1.82-3.63), p < 0.001) was found among patients treated with SGLT-2Is irrespective from EF (HFrEF: RR = 1.96 (95% CI 1.17-3.29), p = 0.011; HFpEF: RR = 3.04 (95% CI 1.88-4.90), p < 0.001). The risk to develop urinary infections was increased among SGLT-2I users in the overall population (RR = 1.13 (95% CI 1.00-1.28), p = 0.046) and in the HFpEF setting (RR = 1.19 (95% CI 1.02-1.38), p = 0.029), whereas no differences have been reported in HFrEF (RR = 1.05 (95% CI 0.81-1.36), p = 0.725) and in non-chronic HF setting (RR = 1.04 (95% CI 0.75-1.46), p = 0.806). SGLT-2Is increase the risk of urinary and genital infections in HF patients. In HFpEF patients, the treatment increases the risk of urinary infections compared to placebo, whereas SGLT-2Is reduce the risk of acute kidney disease in patients with HFrEF.

Indexed as

Acute Kidney InjuryDiabetic KetoacidosisFractures, BoneHeart FailureHyperkalemiaHypoglycemiaHypokalemiaGlucoseHumansStroke VolumeGlucoseAdverse effectsHeart failureHFpEFHFrEFNon-chronic heart failureSodium-glucose cotransporter-2 inhibitor

Identifiers

PMID37917192
OpenAlexW4388226035

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.