Am Heart J. 2021 Nov;241:74-82. doi: 10.1016/j.ahj.2021.07.003. Epub 2021 Jul 18.

Impact of oral soluble guanylate cyclase stimulators in heart failure: A systematic review and Meta-analysis of randomized controlled trials.

American heart journal

Nima Moghaddam, Navraj Malhi, Mustafa Toma

PMID: 34283990 DOI: 10.1016/j.ahj.2021.07.003

Abstract

BACKGROUND: Soluble guanylate cyclase (sGC) stimulators are a novel class of medications with emerging role in heart failure (HF). The aim of this study is to evaluate the efficacy and safety of oral sGC stimulators in patients with HF with reduced and preserved ejection fraction (HFrEF and HFpEF) by pooling data from all available randomized control trials (RCT).

METHODS: A comprehensive search of electronic databases from 2000-2020 was performed. Seven RCTs, three HFrEF and four HFpEF studies, were identified. The follow-up duration ranged from 1 month to a median of 10.8 months. A random-effects meta-analysis was conducted to summarize the studies.

RESULTS: The study population included 7190 patients: 5707 HFrEF and 1483 HFpEF patients. In HFrEF, oral sGC stimulators reduced the composite incidence of HF hospitalization and cardiovascular death (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.78-0.97; I

CONCLUSION: Oral sGC stimulators are well tolerated in HF and reduce the incidence of HF hospitalization but not cardiovascular death among patients with HFrEF. However, there are no apparent benefits in HFpEF.

Copyright © 2021 Elsevier Inc. All rights reserved.

Substances

• Enzyme Activators
• Soluble Guanylyl Cyclase

MeSH terms

• Enzyme Activators / pharmacology*
• Heart Failure* / drug therapy
• Heart Failure* / metabolism
• Heart Failure* / mortality
• Hospitalization / statistics & numerical data*
• Humans
• Mortality
• Randomized Controlled Trials as Topic
• Soluble Guanylyl Cyclase / metabolism*

Publication Types

• Journal Article
• Meta-Analysis
• Systematic Review