SGLT-2 inhibitors did not significantly decrease pulse wave velocity overall, but significantly reduced it by 0.17 m/s in patients with type 2 diabetes.
Meta-Analysis (n=452)
Do SGLT-2 inhibitors reduce pulse wave velocity in adult subjects with or without type 2 diabetes mellitus?
SGLT-2 inhibitors do not significantly reduce arterial stiffness overall, but they induce a modest, significant reduction in pulse wave velocity in patients with type 2 diabetes mellitus.
BACKGROUND: Arterial stiffness represents an established cardiovascular risk marker. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have significant cardio-protective effects. Herein we sought to determine the effect of SGLT-2 inhibitors on pulse wave velocity (PWV). METHODS: February 2022 for randomized controlled trials (RCTs) enrolling adult subjects with or without type 2 diabetes mellitus (T2DM), assigned to a SGLT-2 inhibitor versus control and addressing their effect on PWV. We set as primary efficacy outcome the change in PWV with SGLT-2 inhibitors versus placebo or control. RESULTS: We pooled data from six trials in a total of 452 enrolled participants assigned either to SGLT-2 inhibitor or control. Overall, SGLT-2 inhibitor treatment compared to control resulted in a nonsignificant decrease in PWV. Exclusion of a trial utilizing cardiac magnetic resonance imaging for the assessment of PWV demonstrated that SGLT-2 inhibitors induce a significant reduction in PWV by 0.21 m/s. When we restricted our analysis to RCTs enrolling subjects with T2DM, we observed that SGLT-2 inhibitor compared to control resulted in a significant decrease in PWV by 0.17 m/s. CONCLUSION: SGLT-2 inhibitors do not decrease PWV in patients with established cardiovascular disease or cardiovascular risk factors. However, we have shown that SGLT-2 inhibitors lead to a slight, but significant decrease in PWV in patients with T2DM. The latter finding is of great value, based on the significant correlation between PWV and micro- and macro-vascular complications of T2DM.
Patoulias et al. (Mon,) conducted a meta-analysis in Type 2 diabetes mellitus or cardiovascular risk factors (n=452). Sodium-glucose co-transporter-2 (SGLT-2) inhibitors vs. Placebo or control was evaluated on Change in pulse wave velocity (PWV). SGLT-2 inhibitors did not significantly decrease pulse wave velocity overall, but significantly reduced it by 0.17 m/s in patients with type 2 diabetes.
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