Differential effects of sodium–glucose cotransporter 2 inhibitors on cardiovascular and renal outcomes according to renal function: a dose–response meta-analysis involving 10 randomized clinical trials and 71 553 individuals
Authors' conclusion
The protective effects of SGLT2i for reducing most adverse cardiovascular and renal outcomes persisted in patients with variable degrees of renal impairment. The observed benefits such as preventing CV death, HF worsening, or stroke may be greater for patients with more severe CKD. Considering the cardiovascular and renal benefits associated with SGLT2i treatment, patients with CKD should be treated aggressively to improve outcomes.
Study context
- Population
- RCTs comparing SGLT2i with placebo reporting cardiovascular or renal outcomes (PubMed through May 25, 2022)
- Comparison
- SGLT2i vs placebo, by baseline eGFR
- Outcome
- MACE: CV death, nonfatal MI and nonfatal ischemic stroke; association of risk ratio with baseline eGFR
Methodological detailsdose–response meta-regression, linear and nonlinear meta-regression
- Dose–response meta-regression
- Linear and nonlinear meta-regression
Pooled result
As reported in the abstract
- Risk ratios for major adverse cardiovascular events (MACE) with SGLT2i not significantly related to baseline eGFR
Further pooled results
CV death, nonfatal myocardial infarction (MI), hospitalization for heart failure (HHF) and composite renal outcomes vs baseline eGFR
- RRs with SGLT2i not significantly related to baseline eGFR
Stroke vs baseline eGFR (meta-regression)
- Positive association between eGFR and stroke risk with SGLT2i use: regression coefficient β
- β = .0109, 95% CI 0.0029-0.0188
Composite of CV death and HHF vs baseline eGFR (meta-regression)
- Similar positive association between eGFR and composite of CV death and HHF: β
- β = .0025, 95% CI 0.0000-0.0051
Meta-regression including diabetes mellitus (DM), heart failure (HF) and atherosclerotic cardiovascular disease (ASCVD) covariates
- Consistent with primary analyses for most outcomes
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →