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SGLT2 inhibitors for prevention of primary and secondary cardiovascular outcomes: A meta-analysis of randomized controlled trials

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HEART & LUNG
卷 59, 期 -, 页码 109-116

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MOSBY-ELSEVIER
DOI: 10.1016/j.hrtlng.2023.02.009

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SGLT2i; Cardiovascular events; Myocardial infarction; Cardiovascular death; Meta-analysis

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Several clinical studies have shown that sodium-glucose cotransporter 2 inhibitors (SGLT2i) can reduce cardiovascular risks, such as heart failure, myocardial infarction, and cardiovascular death. This meta-analysis of 11 studies found that SGLT2i significantly reduced major adverse cardiovascular events and hospitalization due to heart failure in patients with or without a history of myocardial infarction and coronary atherosclerotic disease.
Background: Many clinical studies have shown that sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce cardiovascular risks, such as heart failure, myocardial infarction and cardiovascular death. Objective: To investigate the use of SGLT2i for the prevention of primary and secondary cardiovascular outcomes. Methods: Pubmed, Embase and Cochrane libraries databases were searched and meta-analysis was performed using Revman 5.4. Results: Eleven studies with a total of 34,058 cases were analyzed. SGLT2i significantly reduced major adverse cardiovascular events (MACE) in patients with prior myocardial infarction (MI) (OR 0.83, 95% CI 0.73-0.94, p = 0.004), no prior MI (OR 0.82, 95% CI 0.74-0.90, p<0.0001), prior coronary atherosclerotic disease (CAD) (OR 0.82, 95% CI 0.73-0.93, p = 0.001) and no prior CAD (OR 0.82, 95% CI 0.76-0.91, p = 0.0002) compared with placebo. In addition, SGLT2i significantly reduced hospitalization due to heart failure (HF) in patients with prior MI (OR 0.69, 95% CI 0.55-0.87, p = 0.001), no prior MI (OR 0.63, 95% CI 0.55-0. 72, p<0.00001), prior CAD (OR 0.65, 95% CI 0.53-0.79, p<0.0001) and no prior CAD (OR 0.65, 95% CI 0.56-0.75, p<0.00001) compared with placebo. SGLT2i reduced cardiovascular mortality and all-cause mortality events. MI (OR 0.79, 95% CI 0.70-0.88, p<0.0001), renal damage (OR 0.73, 95% CI 0.58-0.91, p = 0.004), all-cause hospitalization (OR 0.89, 95% CI 0.83-0.96, p = 0.002), systolic and diastolic blood pressure were all significantly reduced in patients receiving SGLT2i. Conclusion: SGLT2i was effective in prevention of primary and secondary cardiovascular outcomes. (c) 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

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