TY - JOUR
T1 - Effect of SGLT2 Inhibitors on Cardiovascular Outcomes Across Various Patient Populations
AU - Usman, Muhammad Shariq
AU - Siddiqi, Tariq Jamal
AU - Anker, Stefan D.
AU - Bakris, George L.
AU - Bhatt, Deepak L.
AU - Filippatos, Gerasimos
AU - Fonarow, Gregg C.
AU - Greene, Stephen J.
AU - Januzzi, James L.
AU - Khan, Muhammad Shahzeb
AU - Kosiborod, Mikhail N.
AU - McGuire, Darren K.
AU - Piña, Ileana L.
AU - Rosenstock, Julio
AU - Vaduganathan, Muthiah
AU - Verma, Subodh
AU - Zieroth, Shelley
AU - Butler, Javed
N1 - Publisher Copyright:
© 2023 American College of Cardiology Foundation
PY - 2023/6/27
Y1 - 2023/6/27
N2 - Background: The effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on heart failure (HF) outcomes and cardiovascular (CV) death in patients with varying combinations of type 2 diabetes mellitus (T2DM), HF, and chronic kidney disease (CKD) are uncertain. Objectives: The authors conducted a meta-analysis assessing the effects of SGLT2 inhibitors on HF outcomes and CV death across different patient populations. Methods: Online databases were queried up to November 2022 for primary and secondary analyses of trials of SGLT2 inhibitors in patients with HF, T2DM, or CKD. Outcomes of interest were composite of first heart failure hospitalization (HFH) or CV death (first HFH/CV death), first HFH, and CV death. Data were pooled by means of a random-effects model to derive HRs and 95% CIs. Results: Thirteen trials (n = 90,413) were included. Compared with placebo, SGLT2 inhibitors reduced the risk of first HFH/CV death by 24% in HF (HR: 0.76; 95% CI: 0.72-0.81), 23% in T2DM (HR: 0.77; 95% CI: 0.73-0.81), and 23% in CKD (HR: 0.77; 95% CI: 0.72-0.82). The benefit was consistent in HF with reduced or preserved ejection fraction, HF with or without T2DM, and HF with or without CKD. The benefit was also consistent in T2DM with or without CKD, T2DM without HF, CKD without HF, and in patients with all 3 comorbidities. SGLT2 inhibitors significantly reduced CV death by 16% in HF, 15% in T2DM, and 12% in CKD. Conclusions: SGLT2 inhibitors reduce HF events and CV death in cohorts of HF, T2DM and CKD, and these effects appear consistent in patients with varying combinations of these diseases.
AB - Background: The effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on heart failure (HF) outcomes and cardiovascular (CV) death in patients with varying combinations of type 2 diabetes mellitus (T2DM), HF, and chronic kidney disease (CKD) are uncertain. Objectives: The authors conducted a meta-analysis assessing the effects of SGLT2 inhibitors on HF outcomes and CV death across different patient populations. Methods: Online databases were queried up to November 2022 for primary and secondary analyses of trials of SGLT2 inhibitors in patients with HF, T2DM, or CKD. Outcomes of interest were composite of first heart failure hospitalization (HFH) or CV death (first HFH/CV death), first HFH, and CV death. Data were pooled by means of a random-effects model to derive HRs and 95% CIs. Results: Thirteen trials (n = 90,413) were included. Compared with placebo, SGLT2 inhibitors reduced the risk of first HFH/CV death by 24% in HF (HR: 0.76; 95% CI: 0.72-0.81), 23% in T2DM (HR: 0.77; 95% CI: 0.73-0.81), and 23% in CKD (HR: 0.77; 95% CI: 0.72-0.82). The benefit was consistent in HF with reduced or preserved ejection fraction, HF with or without T2DM, and HF with or without CKD. The benefit was also consistent in T2DM with or without CKD, T2DM without HF, CKD without HF, and in patients with all 3 comorbidities. SGLT2 inhibitors significantly reduced CV death by 16% in HF, 15% in T2DM, and 12% in CKD. Conclusions: SGLT2 inhibitors reduce HF events and CV death in cohorts of HF, T2DM and CKD, and these effects appear consistent in patients with varying combinations of these diseases.
KW - cardiovascular death
KW - heart failure hospitalization
KW - sodium-glucose cotransporter-2 inhibitors
UR - http://www.scopus.com/inward/record.url?scp=85161574032&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85161574032&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2023.04.034
DO - 10.1016/j.jacc.2023.04.034
M3 - Article
C2 - 37344038
AN - SCOPUS:85161574032
SN - 0735-1097
VL - 81
SP - 2377
EP - 2387
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 25
ER -