Exploring the Efficacy of Triple Therapy with SGLT2 Inhibitors, GLP-1 Receptor Agonists, and Mineralocorticoid Receptor Antagonists on Cardiovascular and Renal Outcomes in Advanced Heart Failure: A Meta-analysis

Background Heart failure (HF) represents a significant global health concern characterized by a progressive decline in cardiac function, resulting in high morbidity and mortality rates. The advent of novel pharmacological agents, particularly sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and mineralocorticoid receptor antagonists (MRAs), has shown promise in improving cardiovascular and renal outcomes in patients with HF. Objective This meta-analysis aims to systematically evaluate the efficacy of triple therapy involving SGLT2 inhibitors, GLP-1 receptor agonists, and MRAs on cardiovascular and renal outcomes in patients suffering from advanced heart failure. Methods A thorough literature search was conducted across significant databases, including PubMed, Scopus, and Google Scholar, to identify peer-reviewed studies published up to September 2017 to August 2024. The search strategy utilized relevant Medical Subject Headings (MeSH) and free-text keywords. Studies included were original research articles, systematic reviews, and meta-analyses focusing on the impact of the combined pharmacological therapies on patients with heart failure. Two reviewers performed Data extraction independently, and statistical analyses were executed to assess pooled effect sizes and heterogeneity. Results The analysis encompassed 11 studies, revealing significant reductions in cardiovascular risk and improvements in renal outcomes associated with the triple therapy approach. The pooled effect sizes indicated a notable efficacy of combined therapies in managing heart failure and enhancing overall patient outcomes. Conclusion The findings from this meta-analysis support the use of SGLT2 inhibitors, GLP-1 receptor agonists, and MRAs in clinical practice for patients with heart failure. Integrating these therapeutic strategies into management protocols can significantly improve cardiovascular and renal health, ultimately reducing mortality and morbidity in this patient population.