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Cardiovascular Effects of Stimulators of Soluble Guanylate Cyclase Administration: A Meta-analysis of Randomized Controlled Trials

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Abstract

Purpose of review

Heart failure (HF) is one of the main causes of cardiovascular mortality in the western world. Despite great advances in treatment, recurrence and mortality rates remain high. Soluble guanylate cyclase is an enzyme which, by producing cGMP, is responsible for the effects of vasodilation, reduction of cardiac pre- and after-load and, therefore, the improvement of myocardial performance. Thus, a new therapeutic strategy is represented by the stimulators of soluble guanylate cyclase (sGCs). The aim of this meta-analysis was to analyze the effects deriving from the administration of sGCs, in subjects affected by HF.

A systematic literature search of Medline, SCOPUS, and Google Scholar was conducted up to December 2022 to identify RCTs assessing the cardiovascular effects, as NT-pro-BNP values and ejection fraction (EF), and all-cause mortality, of the sGCs. Quantitative data synthesis was performed using a random-effects model, with weighted mean difference (WMD) and 95% confidence interval (CI) as summary statistics.

Recent findings

The results obtained documented a statistically significant improvement in NT-proBNP values (SMD: − 0.258; 95% CI: − 0.398, − 0.118; p < 0.001) and EF (WMD: 0.948; 95% CI: 0.485, 1.411; p < 0.001) in subjects treated with sGCs; however, no significant change was found in the all-cause mortality rate (RR 0.96; 95% CI 0.868 to 1.072; I2, p = 0).

Summary

The sGCs represent a valid therapeutic option in subjects suffering from HF, leading to an improvement in cardiac performance.

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Data Availability

The data are available upon request.

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Authors and Affiliations

  1. Department of Internal Medicine-Mazzoni Hospital, Ascoli Piceno, Italy

    Cosimo Andrea Stamerra & Paolo Di Giosia

  2. Department of Emergency-Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy

    Paolo Giorgini

  3. Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

    Tannaz Jamialahmadi

  4. Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Tannaz Jamialahmadi

  5. Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  6. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

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  1. Cosimo Andrea Stamerra
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Authors' contributions: Conceptualization: CAS, AS Writing original draft: PDG, MG Writing review and editing: PG, TJ Approval of the final version: All authors

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Correspondence to Amirhossein Sahebkar.

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Stamerra, C.A., Di Giosia, P., Giorgini, P. et al. Cardiovascular Effects of Stimulators of Soluble Guanylate Cyclase Administration: A Meta-analysis of Randomized Controlled Trials. Curr Atheroscler Rep (2024). https://doi.org/10.1007/s11883-024-01197-4

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