{"id":"897e57fc91b4","type":"article","url":"https://hartvaat.nl/2022/04/01/glucoseverlagende-middelen-bij-niet-diabetisch-hf-bayesiaanse-netwerkmeta-analys/","title":"Glucoseverlagende middelen bij niet-diabetisch HF: Bayesiaanse netwerkmeta-analyse","title_en":"Can glucose-lowering medications improve outcomes in non-diabetic heart failure patients? A Bayesian network meta-analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":["diabetes-en-hart"],"journal":"ESC heart failure","doi":"10.1002/ehf2.13822","source_url":"https://doi.org/10.1002/ehf2.13822","authors":["Trevor Yeong","Aaron Shengting Mai","Oliver Z H Lim","Cheng Han Ng","Yip Han Chin","Phoebe Tay","Chaoxing Lin","Mark Muthiah","Chin Meng Khoo","Mayank Dalakoti","Poay-Huan Loh","Mark Chan","Tiong-Cheng Yeo","Roger Foo","Raymond Wong","Nicholas W S Chew","Weiqin Lin"],"significance":7,"published":"2022-04-01","source_date":"2022-04-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/betablokkers-bij-hartfalen/"],"congress":"","summary_en":"This Bayesian network meta-analysis explored whether glucose-lowering medications, particularly SGLT2 inhibitors and GLP-1 agonists, improve outcomes in non-diabetic heart failure patients, finding evidence supporting SGLT2 inhibitor use independent of glycemic indication.","created":"2026-07-03T10:29:41Z","updated":"2026-07-03T13:28:48Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Bayesiaanse netwerkmeta-analyse die de uitkomsten van glucoseverlagende medicatie onderzocht bij niet-diabetische HF-patiënten.","abstract_original":"AIMS: The cardioprotective effects of glucose-lowering medications in diabetic patients with heart failure (HF) are well known. Several large randomized controlled trials (RCTs) have recently suggested that the cardioprotective effects of glucose-lowering medications extend to HF patients regardless of diabetic status. The aim of this study was to conduct a Bayesian network meta-analysis to evaluate the impact of various glucose-lowering medications on the outcomes of non-diabetic HF patients. METHODS AND RESULTS: Medline and Embase were searched for RCTs investigating the use of glucose-lowering medications in non-diabetic HF patients in August 2021. Studies were included in accordance with the inclusion and exclusion criteria, and data were extracted with a pre-defined datasheet. Primary outcomes include serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels, left ventricular ejection fraction (LVEF), and maximal oxygen consumption (PVO2 ). A Bayesian network meta-analysis was performed to compare the effectiveness of different classes of glucose-lowering medications in improving HF outcomes. Risk-of-bias was assessed using Cochrane Risk-of-Bias tool 2.0 for randomized trials (ROB2). Seven RCTs involving 2897 patients were included. Sodium-glucose transporter 2 inhibitor (SGLT2i) was the most favourable in lowering NT-proBNP, with the significant reduction in NT-proBNP when compared with glucagon-like peptide-1 receptor agonists (GLP1-RA) [mean differences (MD): -229.59 pg/mL, 95%-credible intervals (95%-CrI): -238.31 to -220.91], metformin (MD: -237.15 pg/mL, 95%-CrI: -256.19 to -218.14), and placebo (MD: -228.00 pg/mL, 95%-CrI: -233.99 to -221.99). SGLT2i was more effective in improving LVEF for HF with reduced ejection fraction patients relative to GLP1-RA (MD: 8.09%, 95%-CrI: 6.30 to 9.88) and placebo (MD: 6.10%, 95%-CrI: 4.37 to 7.84). SGLT2i and GLP1-RA were more favourable to placebo in improving PVO2 , with significant increase of PVO2 at a MD of 1.60 mL/kg/min (95%-CrI: 0.63 to 2.57) and 0.86 mL/kg/min (95%-CrI: 0.66 to 1.06), respectively. All three drugs had comparable safety profiles when compared with placebo. CONCLUSIONS: This Bayesian network meta-analysis demonstrated that SGLT2i, when compared with GLP1-RA and metformin, was superior in improving LVEF in HF with reduced ejection fraction patients, as well as improving PVO2 and NT-proBNP in non-diabetic HF patients. Further large-scale prospective studies are needed to confirm these preliminary findings."}