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All Journal Medicinus : Jurnal Kedokteran Jurnal Cahaya Mandalika
Mardiah, Harisa
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Humanities Languange, Linguistic, Communication & Media Medicine & Pharmacology Public Health

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Comparative Effectiveness of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Heart Failure: A Systematic Review Putri, Evira Agustina; Putri, Adinda Wafdani; Andreago; Welliangan, Ariyani Sudhamma; Guantoro, Vincent; Mardiah, Harisa
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10164

Abstract

Background: Heart failure (HF) affects over 64 million individuals globally and is associated with high morbidity and mortality, particularly in patients with type 2 diabetes mellitus (T2DM). Sodium-glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are emerging therapies with reported cardiovascular benefits. However, their comparative efficacy in HF-specific outcomes remains unclear. This systematic review aimed to assess and compare the safety and efficacy of SGLT2 inhibitors and GLP-1 RAs in patients with HF. Methods: We systematically searched PubMed, EMBASE, and Scopus up to 1 May 2025 for randomized controlled trials (RCTs) evaluating SGLT2 inhibitors or GLP-1 RAs in adults with HF. Primary outcomes included all-cause and cardiovascular mortality; secondary outcomes included HF hospitalization and major adverse cardiovascular events (MACE). Risk of bias was assessed using the Cochrane RoB 2 tool and certainty of evidence with the GRADE approach. Result: Fourteen RCTs comprising 30,867 patients (52.2% female; 63.2% with T2DM) were included. SGLT2 inhibitors significantly reduced cardiovascular mortality (RR: 0.85, 95% CI: 0.78–0.93, p < 0.001, I² = 14%), all-cause mortality (RR: 0.88, 95% CI: 0.81–0.95, p = 0.002, I² = 21%), and HF hospitalizations (RR: 0.72, 95% CI: 0.67–0.77, p < 0.001, I² = 0%). GLP-1 RAs did not demonstrate significant effects on these outcomes. Overall risk of bias was low to moderate; GRADE certainty ranged from moderate to high. Conclusions: SGLT2 inhibitors provide consistent reductions in mortality and hospitalization in HF patients across glycemic statuses. GLP-1 RAs showed limited benefit in HF-specific outcomes, supporting the preferential use of SGLT2 inhibitors in HF treatment strategies.
Hubungan Kepatuhan Minum Obat Antihipertensi Dengan Perubahan Tekanan Darah Pasien Lansia Dengan Hipertensi di UPTD Puskesmas Panyabungan Jae Mardiah, Harisa
Jurnal Cahaya Mandalika ISSN 2721-4796 (online) Vol. 4 No. 1 (2023)
Publisher : Institut Penelitian Dan Pengambangan Mandalika Indonesia (IP2MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36312/jcm.v4i1.3341

Abstract

Hipertensi merupakan the silent killer dengan 9,4 juta orang meninggal setiap tahunnya akibat komplikasi hipertensi seperti penyakit jantung, stroke, dan penyakit kardiovaskuler lainnya. Obat antihipertensi dapat mengontrol tekanan darah dan menurunkan risiko komplikasi kardiovaskular. Namun, penggunaan obat saja tidak cukup untuk menghasilkan efek pengontrolan tekanan darah jangka panjang apabila tidak didukung dengan kepatuhan pengobatan. Penelitian ini bertujuan untuk mengetahui hubungan kepatuhan minum obat antihipertensi dengan perubahan tekanan darah pasien lansia dengan hipertensi di UPTD Puskesmas Panyabungan Jae. Penelitian studi analitik dengan desain cross-sectional. Diperoleh 54 sampel dari data kuesioner dan rekam medis secara purposive sampling yang disesuaikan dengan kriteria dan variabel penelitian. Mayoritas kelompok tingkat kepatuhan minum obat cukup patuh (40,7%) dan pasien dengan tekanan darah tetap (37,0%). Pasien yang cukup patuh dengan tekanan darah tetap (25,9%), patuh minum obat dengan tekanan darah menurun (24,1%), dan tidak patuh minum obat dengan tekanan darah meningkat (20,4%). Hasil uji Fisher’s Exact antara kepatuhan minum obat antihipertensi dengan perubahan tekanan darah pasien lansia dengan hipertensi diperoleh nilai p = 0.001, nilai r = 0.001 (α< 0.05) dengan koefisien korelasi = 0.672 dan nilai OR (95% CI) = 11.73 (2.98-46.19). Ada korelasi antara kepatuhan minum obat antihipertensi dengan perubahan tekanan darah pasien lansia dengan hipertensi dengan arah korelasi positif dan kekuatan hubungan yang signifikan. Pasien yang tidak patuh minum obat antihipertensi 11 kali berisiko mengalami peningkatan tekanan darah.
Co-Authors Andreago Guantoro, Vincent Putri, Adinda Wafdani Putri, Evira Agustina Welliangan, Ariyani Sudhamma