SGLT2 Inhibitors: Effect on Myocardial Infarction and Stroke in Type 2 Diabetes
Authors' conclusion
SGLT2is reduce MACE without any discernable significant reduction of the incidence of MI or stroke (fatal and nonfatal), probably implicating mechanisms unrelated to anti-atherogenic effects.
Study context
- Population
- Patients with T2D in cardiovascular outcome trials
- Participants
- 42,568 patients4 trials
- Comparison
- SGLT2i vs placebo
- Outcome
- Fatal and nonfatal MI, stroke, and total MI and stroke
Methodological detailsevent-driven, randomized, Mantel Haenszel fixed model
- Event-driven
- Randomized
- Mantel Haenszel fixed model
Pooled result
As reported in the abstract
Fatal and nonfatal MI and stroke
Each group vs placeboEstimate (95% CI)
SGLT2i
MH risk ratio (fatal and nonfatal MI) 0.93(0.85–1.01)
SGLT2i
MH risk ratio (fatal and nonfatal stroke) 1.00(0.89–1.11)
- Total MACE events
- 4176
- Myocardial infarction (MI) events
- 2157
- Stroke events
- 1288
Further pooled results
Total atherosclerotic cardiovascular disease (ASCVD) events
- Mantel Haenszel (MH) risk ratio
- 0.95 (95% CI, 0.89-1.02) (95% CI)
All nonfatal ASCVD (combined nonfatal MI and nonfatal stroke)
- MH risk ratio
- 0.94 (95% CI, 0.88-1.02) (95% CI)
Original publication
SGLT2 Inhibitors: Effect on Myocardial Infarction and Stroke in Type 2 Diabetes. J Clin Endocrinol Metab. Published 28 February 2023. doi:10.
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