Neutral effects of SGLT2 inhibitors in acute coronary syndromes, peripheral arterial occlusive disease, or ischemic stroke: a meta-analysis of randomized controlled trials
Authors' conclusion
Our results appear to contradict the mainstream concepts regarding the cardiovascular effects of SGLT2i since we found no significant therapeutic benefits in SGLT2i to reduce the incidence of ACS, PAOD, or IS when compared to placebo or oral hypoglycemic drugs.
Study context
- Population
- Patients with T2D in randomized clinical trials (RCTs) (PubMed, Embase, Cochrane library, clinicaltrial.gov, until November 2022)
- Participants
- 79,504 patients43 RCTs
- Comparison
- SGLT2i vs placebo or oral hypoglycemic drugs
- Outcome
- ACS, PAOD and ischemic stroke
Methodological detailsfixed effects model, risk-of-bias (RoB2) risk-of-bias assessment
- Fixed effects model
- RoB2 risk-of-bias assessment
Pooled result
As reported in the abstract
ACS, PAOD, ischemic stroke
SGLT2i vs ControlRelative risk (95% CI)
ACS
0.97(0.89–1.05)
PAOD
0.98(0.78–1.24)
Ischemic stroke
0.95(0.79–1.14)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| CV mortality | 0.85 (0.77–0.93) | |
| All-cause mortality | 0.88 (0.82–0.94) | |
| 0.512Relative risk (log scale) |
Primary outcomes by individual SGLT2i (subgroup analysis)
- None of canagliflozin, dapagliflozin, empagliflozin, ertugliflozin significantly altered outcomes separately
Original publication
Neutral effects of SGLT2 inhibitors in acute coronary syndromes, peripheral arterial occlusive disease, or ischemic stroke: a meta-analysis of randomized controlled trials. Cardiovasc Diabetol. Published 13 March 2023. doi:10.
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