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December 29, 2022European journal of medical researchOpen Access

Sodium-glucose co-transporter 2 inhibitors in heart failure with mildly reduced or preserved ejection fraction: an updated systematic review and meta-analysis

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Why the study?

HFmrEF and HFpEF carry significant morbidity and mortality, and pooling data from all available randomized controlled trials was needed to investigate the effects of SGLT2 inhibitors.

Do SGLT2 inhibitors reduce the composite of HF hospitalization or cardiovascular death in patients with HFmrEF or HFpEF?

Comparison

SGLT2 inhibitors vs control

Design

Systematic review and meta-analysis of randomized controlled trials

Authors

YWYintang WangTGTong GaoCMChang Meng

Discussion

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Overview

May support outcome benefits with SGLT2 inhibitors in HFmrEF/HFpEF; leaves open confirmation via dedicated prospective trials.

Key Points

  • To assess the efficacy and safety of SGLT2 inhibitors on major cardiovascular outcomes and hospitalizations in patients with heart failure with mildly reduced or preserved ejection fraction.
  • Systematic review and meta-analysis of randomized controlled trials published from database inception through November 2022 (registered with INPLASY 2022110095).
  • Pooled trial-level data from 6 randomized clinical trials involving 15,989 participants with left ventricular ejection fraction greater than 40%.
  • SGLT2 inhibitors significantly reduced the composite endpoint of heart failure hospitalization or cardiovascular death (HR: 0.79, 95% CI: 0.72–0.85; P < 0.00001) and heart failure hospitalizations alone (HR: 0.74, 95% CI: 0.67–0.82; P < 0.00001).
  • Hospitalization reductions were consistent across HFmrEF (HR: 0.76, 95% CI: 0.67–0.87; P < 0.0001) and HFpEF subgroups (HR: 0.70, 95% CI: 0.53–0.93; P = 0.01), alongside lower serious adverse events (OR: 0.89, 95% CI: 0.83–0.96; P = 0.002).
  • No statistically significant reductions were observed between treatment arms for isolated cardiovascular mortality or all-cause mortality.

Structured PICO

Do SGLT2 inhibitors reduce the composite of HF hospitalization or cardiovascular death in patients with HFmrEF or HFpEF?

P
Population
15,989 participants from 6 RCTs with heart failure with mildly reduced ejection fraction (HFmrEF) or heart failure with preserved ejection fraction (HFpEF) (LVEF > 40%)
I
Intervention
Sodium-glucose co-transporter 2 (SGLT2) inhibitors
C
Comparator
Control group (not explicitly detailed in abstract)
O
Outcome
Composite of heart failure (HF) hospitalization or cardiovascular deathcomposite

SGLT2 inhibitors significantly reduce the risk of the composite of cardiovascular death and hospitalization for heart failure in patients with HFmrEF or HFpEF, supporting their use as fundamental treatment in this population.

Cite This Study

Wang et al. (2022) studied this question.

synapsesocial.com/papers/6a7563ee1646b2abe5036b68https://doi.org/10.1186/s40001-022-00945-z
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effectiveness of SGLT2 inhibitor therapy in treatment of Heart failure: A Meta-Analysis2023
  2. 2Efficacy of SGLT2 Inhibitors in Patients With Heart Failure and Mildly Reduced or Preserved Ejection Fraction: An Updated Systematic Review and Meta-Analysis2026 · 1 citations
  3. 3Sodium-glucose Cotransporter 2 Inhibitors Association with Risk of Heart Failure Hospitalization in Preserved and Mildly Reduced Ejection Fraction, Regardless of Diabetes Mellitus: A Systematic Review and Meta-Analysis2025
  4. 4The role of SGLT 2 inhibitors in heart failure with preserved ejection fraction (HFpEF): a systematic review and meta-analysis of randomized controlled trials2025 · 12 citations
  5. 5Efficacy and safety of sodium-glucose cotransporter-2 inhibitors for heart failure with mildly reduced or preserved ejection fraction: a systematic review and meta-analysis of randomized controlled trials2023 · 8 citations