SGLT2 inhibitors reduced first heart failure hospitalization or cardiovascular death by 24% in HF (HR 0.76), 23% in T2DM (HR 0.77), and 23% in CKD (HR 0.77) compared with placebo.
Meta-Analysis (n=90,413)
Do SGLT2 inhibitors reduce the composite of first heart failure hospitalization or cardiovascular death in patients with heart failure, type 2 diabetes mellitus, or chronic kidney disease?
SGLT2 inhibitors consistently reduce the risk of heart failure hospitalization and cardiovascular death across diverse patient populations with heart failure, type 2 diabetes, and chronic kidney disease.
Effect estimate: HR 0.76 (95% CI 0.72-0.81)
BACKGROUND: The effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on heart failure (HF) outcomes and cardiovascular (CV) death in patients with varying combinations of type 2 diabetes mellitus (T2DM), HF, and chronic kidney disease (CKD) are uncertain. OBJECTIVES: The authors conducted a meta-analysis assessing the effects of SGLT2 inhibitors on HF outcomes and CV death across different patient populations. METHODS: Online databases were queried up to November 2022 for primary and secondary analyses of trials of SGLT2 inhibitors in patients with HF, T2DM, or CKD. Outcomes of interest were composite of first heart failure hospitalization (HFH) or CV death (first HFH/CV death), first HFH, and CV death. Data were pooled by means of a random-effects model to derive HRs and 95% CIs. RESULTS: Thirteen trials (n = 90,413) were included. Compared with placebo, SGLT2 inhibitors reduced the risk of first HFH/CV death by 24% in HF (HR: 0.76; 95% CI: 0.72-0.81), 23% in T2DM (HR: 0.77; 95% CI: 0.73-0.81), and 23% in CKD (HR: 0.77; 95% CI: 0.72-0.82). The benefit was consistent in HF with reduced or preserved ejection fraction, HF with or without T2DM, and HF with or without CKD. The benefit was also consistent in T2DM with or without CKD, T2DM without HF, CKD without HF, and in patients with all 3 comorbidities. SGLT2 inhibitors significantly reduced CV death by 16% in HF, 15% in T2DM, and 12% in CKD. CONCLUSIONS: SGLT2 inhibitors reduce HF events and CV death in cohorts of HF, T2DM and CKD, and these effects appear consistent in patients with varying combinations of these diseases.
“SGLT2 inhibitors improve cardiovascular outcomes in patients with heart failure, type 2 diabetes, chronic kidney disease, atherosclerotic cardiovascular disease, and any combination of these diseases.”
Usman et al. (Thu,) conducted a meta-analysis in Heart failure, type 2 diabetes mellitus, or chronic kidney disease (n=90,413). SGLT2 inhibitors vs. placebo was evaluated on Composite of first heart failure hospitalization (HFH) or CV death (HR 0.76, 95% CI 0.72-0.81). SGLT2 inhibitors reduced first heart failure hospitalization or cardiovascular death by 24% in HF (HR 0.76), 23% in T2DM (HR 0.77), and 23% in CKD (HR 0.77) compared with placebo.