Association of sodium–glucose cotransporter-2 inhibitors with mortality across the spectrum of myocardial infarction: a systematic review and meta-analysis
Pooled result · All-cause mortalityResult — go to the resultHazard ratio 0.79 95% CI 0.68–0.91Authors' conclusion
In this meta-analysis, early and delayed treatment with SGLT2 inhibitors following MI was associated with a significant reduction in all-cause mortality. Furthermore, the presence of T2DM was associated with a greater mortality reduction, while HF was not significantly associated with the outcome.
Study context
- Population
- Post-MI patients; mean (SD) age 62.9 (10.5) years; 24.0% female; 61.2% T2D; 52.1% heart failure (HF)
- Participants
- 26,753 patients5 RCTs4 propensity score-matched (PSM) studies
- Comparison
- SGLT2 inhibitors vs comparator after myocardial infarction (MI)
- Outcome
- All-cause mortality
Methodological detailsmeta-regression, stratified analysis (early vs delayed treatment)
- Meta-regression
- Stratified analysis (early vs delayed treatment)
Pooled result
As reported in the abstract
Hazard ratio
0.79
95% CI 0.68–0.91
P = 0.001
SGLT2 inhibitorsvs comparator after MI
HR 0.79 (95% CI 0.68–0.91); P = 0.001
Further pooled results
All-cause mortality, early treatment (SGLT2i within 8 weeks post-MI)
- Early treatment: consistent effect
- HR 0.76, 95% CI [0.59, 0.98]; p = 0.03; I2 = 65%
- Stratified analysis
- 16,165 (60.4%) patients
All-cause mortality, delayed treatment
- Delayed treatment: consistent effect
- HR 0.81, 95% CI [0.67, 0.98]; p = 0.03; I2 = 60%
- Stratified analysis
- 10,588 (39.6%) patients
Moderators of mortality benefit (meta-regression)
- T2DM a significant moderator of the mortality benefit
- β = - 0.0049; p = 0.0006
Original publication
Association of sodium–glucose cotransporter-2 inhibitors with mortality across the spectrum of myocardial infarction: a systematic review and meta-analysis. Cardiovasc Diabetol. Published 22 January 2025. doi:10.
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