SGLT2 inhibitors decrease cardiovascular death and heart failure hospitalizations in patients with heart failure: A systematic review and meta-analysis

Figures

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  Fig. 1. PRISMA flow diagram of study screening and selection. The search strategy in Embase, PubMed, and Cochrane yielded 3969 studies, of which 44 were fully reviewed for inclusion and exclusion criteria. A total of 15 studies were included in the meta-analysis.

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  Fig. 2. A. Title: All-cause mortality was significantly lower in the SGLT2 inhibitor group. Legend: There was a significant 14% relative risk reduction in all-cause mortality among patients with HF treated with SGLT2 inhibitors compared with placebo (OR 0•86; 95% CI 0•79–0•94). B. Title: Cardiovascular mortality was significantly lower in the SGLT2 inhibitor group. Legend: There was a significant 14% relative risk reduction in cardiovascular mortality among patients with HF treated with SGLT2 inhibitors compared with placebo (OR 0•86; 95% CI 0•78–0•96).

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  Fig. 3. Title: Heart failure hospitalizations were significantly lower in the SGLT2 inhibitor group. Legend: There was a significant 31% relative risk reduction in heart failure hospitalizations among patients with HF treated with SGLT2 inhibitors compared with placebo (OR 0•69; 95% CI 0•62–0•76).

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  Fig. 4. Title: Cardiovascular mortality or hospitalizations for HF was significantly lower in the SGLT2 inhibitor group. Legend: There was a significant 25% relative risk reduction in the composite endpoint of cardiovascular mortality or heart failure hospitalizations among patients with HF treated with SGLT2 inhibitors compared with placebo (OR 0•75; 95% CI 0•70–0•80).

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  Fig. 5. A. Title: Among Black patients, cardiovascular death or HF hospitalizations/urgent visits was significantly lower in the SGLT2 inhibitor group.Legend: In patients with HF who were Black, there was a significant 37% relative risk reduction in the composite of cardiovascular death or HF hospitalizations/urgent visits among those treated with SGLT2 inhibitors compared with placebo (OR 0•63; 95% CI 0•40–0•99). B. Title: Among White patients, cardiovascular death or HF hospitalizations/urgent visits was significantly lower in the SGLT2 inhibitor group. Legend: In patients with HF who were White, there was a 23% relative risk reduction in the composite of cardiovascular death or HF hospitalizations/urgent visits among those treated with SGLT2 inhibitors compared with placebo (OR 0•77; 95% CI 0•65–0•91).

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  Fig. 6. A. Title: Cardiovascular death or HF hospitalizations/urgent visits in the subgroup of HF with preserved ejection fraction. Legend: In the subgroup of HF with preserved ejection fraction, there was a 25% relative risk reduction in the composite endpoint of cardiovascular death or HF hospitalizations/urgent visits among those treated with SGLT2 inhibitors compared with placebo (OR 0•75; 95% CI 0•62–0•91). B. Title: Cardiovascular death or HF hospitalizations/urgent visits in the subgroup of HF with reduced ejection fraction. Legend: In the subgroup of HF with reduced ejection fraction, there was a 25% relative risk reduction in the composite endpoint of cardiovascular death or HF hospitalizations/urgent visits among those treated with SGLT2 inhibitors compared with placebo (OR 0•75; 95% CI 0•69–0•81).