SGLT-2 inhibitors reduced the risk of primary composite cardiovascular outcomes in heart failure patients regardless of sex, but females had a significantly greater occurrence of these outcomes compared to males (OR 1.32).
Meta-Analysis (n=21,947)
Yes
Do SGLT-2 inhibitors reduce the composite of cardiovascular death and heart failure hospitalizations in patients with heart failure across both sexes?
SGLT-2 inhibitors effectively reduce cardiovascular death and heart failure hospitalizations in both men and women with heart failure, although women experience a higher overall rate of these events.
Effect estimate: OR 1.32 (95% CI 1.17-1.48)
p-value: p=0.0002
In patients with heart failure (HF), randomized controlled trials (RCTs) of sodium-glucose transporter-2 inhibitors (SGLT-2is) have proven to be effective in decreasing the primary composite outcome of cardiovascular death and hospitalizations for HF. A recently published meta-analysis showed that the use of SGLT-2is among women with diabetes resulted in less reduction in primary composite outcomes compared with men. This study aims to explore potential sex differences in primary composite outcomes among patients with HF treated with SGLT-2is. We systematically searched the medical database from 2017 to 2022 and retrieved all the RCTs using SGLT-2is with specified cardiovascular outcomes. We used the PRISMA (Preferred Reporting Items for a Review and Meta-analysis) method to screen for eligibility. We evaluated the quality of studies using the Cochrane Risk of Bias tool. We pooled the hazard ratio (HR) of the primary composite outcomes in both sexes, performed a meta-analysis, and calculated the odds ratio (OR) of the primary composite outcomes based on sex. We included 5 RCTs with a total number of 21,947 patients. Of these, 7837 (35.7 %) were females. Primary composite outcomes were significantly lower in males and females taking SGLT-2is compared to placebo (males - HR 0.77; 95 % CI 0.72 to 0.84; p = 0.00001; females - HR 0.75; 95 % CI 0.67 to 0.84; p = 0.00001). Pooled data from four of the RCTs (n = 20,725) revealed a greater occurrence of the primary composite outcomes in females compared with males (OR 1.32; 95 % CI 1.17 to 1.48; p = 0.0002). SGLT-2is reduce the risk of primary composite outcomes in patients with HF, regardless of sex; however, the benefits were less pronounced in women. Further research needs to be done to better explain these observed differences in outcomes.
Rivera et al. (Mon,) conducted a meta-analysis in Heart failure (n=21,947). SGLT-2 inhibitors vs. Placebo was evaluated on Composite of cardiovascular death, hospitalization for heart failure, and urgent visit for heart failure (occurrence in females vs. males) (OR 1.32, 95% CI 1.17-1.48, p=0.0002). SGLT-2 inhibitors reduced the risk of primary composite cardiovascular outcomes in heart failure patients regardless of sex, but females had a significantly greater occurrence of these outcomes compared to males (OR 1.32).