HYBRID EVENT: You can participate in person at Valencia, Spain or Virtually from your home or work.

4th Edition of Cardiology World Conference

September 18-20, 2022 | Hybrid Event

September 18 -20, 2023 | Valencia, Spain
Cardio 2023

Billy Joseph David

Billy Joseph David, Speaker at Cardiology Conferences
St. Luke’s Medical Center, Philippines
Title : Sodium-glucose cotransporter-2 inhibitors and health-related quality of life outcomes in all types of heart failure: a systematic review and meta-analysis


Introduction: Exercise intolerance in patients with heart failure leads to a lower quality of life. An increasing number of studies suggest that early initiation of guided-directed medical therapy (GDMT) leads to better outcomes. Sodium-glucose co-transporter-2 (SGLT-2) inhibitor is one of the cornerstones in heart failure treatment, but its effectiveness in improving quality of life remains uncertain. This meta-analysis aims to determine the outcomes of heart failure symptoms and cardiovascular death in all types of heart failure.
Methods: A comprehensive search of randomized controlled trials (RCT) was conducted examining the use of SGLT-2 inhibitors in all types of heart failure compared to placebo. Outcome measures for cardiovascular death and heart failure symptoms using the Kansas City Cardiomyopathy Questionnaire - Total Symptom Score (KCCQ-TSS) in the early phase of treatment and at 8 months were extracted and analyzed using random effects model on both dichotomous and generic inverse variance data types via Review Manager V5.4. The KCCQ-TSS ranges from 0 to 100, with higher scores indicating fewer symptoms and physical limitations associated with heart failure.
The treatment effect was shown as a win ratio, in which a value greater than 1 indicates superiority.
Results: There were five studies included in the meta-analysis with 21,255 subjects analyzed. There were improvement in heart failure symptoms based on the KCCQ-TSS (HR 3.39 [95%CI: 2.95-3.89] I2 = 68%, p<0.00001) with substantial heterogeneity. The major source of heterogeneity identified was the interval when the KCCQ-TSS was performed, hence a sub-group analysis that specifically monitored patients on the 8th month of treatment was done which showed improvement in heart failure symptoms (HR 3.16 [95%CI: 2.98-3.36) I2=8%, p<0.00001) in SGLT-2 inhibitors compared to placebo group. There was also a higher rate of cardiovascular death in the placebo group which was statistically significant (RR 0.87 [95%CI: 0.80-0.95] I2=0, p=0.002).
Conclusion: The meta-analysis showed that initiation of SGLT-2 inhibitors resulted in marked improvement of heart failure symptoms which may potentially lead to improvement of patients’ quality of life. Furthermore, the study showed a decreased rate of cardiovascular death after initiation of SGLT-2 inhibitors. Therefore, SGLT-2 inhibitors in all types of heart failure are effective in promoting better quality of life and lowering incidence of cardiovascular
Audeince Takeaway:

  • The audience will learn the effectiveness in using SGLT-2 inhibitors with regards to the quality of       life measured by the KCCQ-TSS.
  • They will be able to determine the risk of rehospitalization in adding SGLT-2 inhibitors in the guided-directed medical therapy in patients with heart failure.
  • They will be able to have an overview on the list of RCTs/trials available that studied the quality of life in patients with heart failure after the initiation of SGLT-2 medication and apply it clinically.


Dr. Billy Joseph David is a Level III Medical Resident at St. Luke's Medical Center - Quezon City, Philippines. He finished his medical school at the University of Santo Tomas. His research interests are acute heart failure, antiplatelet therapy and atrial fibrillation. He is one of the Young Investigator Award Session Finalist in the recent European Society of Cardiology (ESC) Acute Cardiovascular Care (ACVC) Congress last March 2022. He is currently an active member of Young Community of ESC ACVC since December 2022. He plans to take cardiology specialization after his medical residency training.