Дапаглифлозин опосредует защитный эффект в отношении фибрилляции/трепетания предсердий и снижает риск смертности от всех причин

Цель. Целью данного исследования было изучение связи между приемом дапаглифлозина и частотой возникновения фибрилляции (ФП) и трепетания предсердий (ТП), а также его влияния на смертность от всех причин у пациентов с сахарным диабетом (СД).
Материалы и методы. Придерживаясь рекомендаций Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), этот метаанализ провел комплексный поиск в базах данных PubMed, Embase и ClinicalTrials.gov по состоянию на июнь 2021 года. Мы сосредоточились на рандомизированных контролируемых испытаниях (РКИ), в которых дапаглифлозин сравнивался с плацебо. Для оценки надежности результатов использовался последовательный анализ (TSA). Все статистические анализы проводились с использованием программного обеспечения Review Manager.
Результаты. Окончательный анализ включал девять исследований, охватывающих в общей сложности 30 235 пациентов. Результаты показали статистически значимое снижение частоты возникновения ФП/ТП в группе дапаглифлозина по сравнению с группой плацебо (относительный риск (RR) = 0,73, 95% доверительный интервал (CI) = 0,59–0,89, p = 0,002), хотя этот результат не был подтвержден TSA. Частота возникновения ФП и смертности от всех причин также была ниже в группе дапаглифлозина, чем в группе плацебо (RR = 0,71, 95% CI = 0,57–0,89, p = 0,003 и RR = 0,90, 95% CI = 0,82–0,98, p = 0,02 соответственно). Однако TSA не подтвердил эти результаты.
Заключение. Дапаглифлозин, по-видимому, оказывает значительный протективный эффект в отношении развития ФП/ТП и может снижать риск смертности от всех причин у пациентов с СД. Однако для подтверждения этих результатов необходимы дальнейшие исследования из-за отсутствия подтверждения по результатам TSA.

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