Key result
SGLT inhibitors cut all-cause mortality ~10% vs placebo in patients with CV risk factors.
Why the study?
Although SGLTis have cardiovascular protective effects, their specific impact on individual hard clinical endpoints and quality of life in patients with cardiovascular risk factors required assessment.
Do SGLTis reduce individual hard clinical endpoints and improve quality of life in patients with cardiovascular risk factors compared to placebo?
Meta-Analysis (n=90,413)
Do SGLTis reduce individual hard clinical endpoints and improve quality of life in patients with cardiovascular risk factors compared to placebo?
Effect estimate: RR 0.90 (95% CI 0.86-0.94)
p-value: p=<0.01
SGLT inhibitors provide robust reductions in hard clinical endpoints including all-cause and cardiovascular mortality, as well as improvements in quality of life across patients with cardiovascular risk factors.
Solidifies the mortality benefit of SGLT inhibitors across broad cardiometabolic risk profiles; reinforces.
AIMS: Sodium-glucose co-transporter inhibitors (SGLTis) have cardiovascular protective effects. We aimed to assess the effects of SGLTis on individual hard clinical endpoints and quality of life (QoL) in patients with cardiovascular risk factors. METHODS AND RESULTS: Data was searched in PubMed, Embase, Cochrane Library and clinicaltrials.gov databases up to February 2024. Randomized controlled trials (RCTs) comparing SGLTis with placebo were included. The primary outcomes were individual hard clinical endpoints (Subset A) and QoL (Subset B). For Subset A, 13 RCTs including 90 413 patients were enrolled (age 66 ± 10.1 years, 35.7% female, follow-up 2.4 ± 0.3 years); as compared with placebo, SGLTis were associated with significantly lower risk of all-cause mortality [risk ratio (RR): 0.90, 95% confidence interval (CI): 0.86-0.94, P < 0.01], cardiovascular mortality (RR: 0.87, 95% CI: 0.82-0.92, P < 0.01), hospitalization for heart failure (HF) (RR: 0.72, 95% CI: 0.68-0.76, P < 0.01), HF events (RR: 0.72, 95% CI: 0.68-0.75, P < 0.01), hospitalization for any cause (RR: 0.91, 95% CI: 0.88-0.93, P < 0.01) and myocardial infarction (MI) (RR: 0.92, 95% CI: 0.85-0.99, P = 0.03). Notably, the favourable effect of SGLTis on all-cause mortality was more pronounced in younger (<65 years) patients (RR: 0.86, 95% CI: 0.81-0.92) and in studies with less female (RR: 0.84, 95% CI: 0.79-0.90). The favourable effect of SGLTis on MI was only observed in patients who received sotagliflozin (RR: 0.47, 95% CI: 0.31-0.73). For Subset B, nine RCTs including 2552 HF patients were enrolled (age 67.8 ± 12.4 years, 36.4% female, follow-up 3.4 ± 1.9 months); SGLTis were associated with significant improvement in QoL as compared with placebo. CONCLUSIONS: In patients with a broad spectrum of cardiovascular risk factors, SGLTis substantially improve individual hard clinical outcomes and QoL.
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Liao et al. (2024) conducted a meta-analysis in Cardiovascular risk factors (n=90,413). Sodium-glucose co-transporter inhibitors (SGLTis) vs. Placebo was evaluated on All-cause mortality (RR 0.90, 95% CI 0.86-0.94, p=<0.01). SGLT inhibitors significantly reduced the risk of all-cause mortality compared with placebo (RR 0.90; 95% CI 0.86-0.94; P<0.01) in patients with cardiovascular risk factors.
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