Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis
Authors' conclusion
SGLT2 inhibitors reduced heart failure events and cardiovascular death in patients with heart failure, type 2 diabetes, chronic kidney disease, and atherosclerotic cardiovascular disease. These effects were consistent across a wide range of subgroups within these populations. This supports the eligibility of a large population with cardiorenal-metabolic diseases for treatment with SGLT2 inhibitors.
Study context
- Population
- Patients with HF, T2D, CKD or atherosclerotic CVD (incl. acute MI) in large SGLT2i trials; PubMed, Cochrane CENTRAL, SCOPUS searched up to Feb 10, 2024
- Participants
- 100,952 patients15 trials
- Comparison
- SGLT2 inhibitors vs placebo
- Outcome
- First hospitalisation for HF, by disease subgroup
Methodological detailsrandom-effects models, large trials (n>1000)
- Random-effects models
- Large trials (n>1000)
Pooled result
As reported in the abstract
SGLT2 inhibitors vs PlaceboHazard ratio (95% CI)
HF; 29% reduction
0.71(0.67–0.77)
T2D; 28% reduction
0.72(0.67–0.77)
CKD; 32% reduction
0.68(0.61–0.77)
Atherosclerotic CVD; 28% reduction
0.72(0.66–0.79)
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| CV death, by disease subgroupSGLT2 inhibitorsvs PlaceboHF; 14% reduction | 0.86 (0.79–0.93) | |
| CV death, by disease subgroupSGLT2 inhibitorsvs PlaceboT2D; 15% reduction | 0.85 (0.79–0.91) | |
| CV death, by disease subgroupSGLT2 inhibitorsvs PlaceboCKD; 11% reduction | 0.89 (0.82–0.96) | |
| CV death, by disease subgroupSGLT2 inhibitorsvs PlaceboAtherosclerotic CVD; 13% reduction | 0.87 (0.78–0.97) | |
| 0.512Hazard ratio (log scale) |
Consistency across 51 subgroups (first HF hospitalisation and CV death)
- Acute MI: reduction in first HF hospitalisation; no effect on CV death
- 22%
- HF with preserved ejection fraction: reduction in first HF hospitalisation; no effect on CV death
- 26%
- Benefit consistent across the majority of the 51 subgroups studied
Original publication
Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. Published 17 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →