Sodium Glucose Cotransporter 2 Inhibitors: Safety and Efficacy in HF Patients With and Without Diabetes

Apr 06, 2023

The following is the summary of “Meta-Analysis on the Safety and Efficacy of Sodium Glucose Cotransporters 2 Inhibitors in Patients With Heart Failure With and Without Diabetes” published in the January 2023 issue of Cardiovascular Disease by Hasan, et al.

In individuals over 60, heart failure (HF) accounts for approximately 64.3 % of all cardiovascular hospitalizations. Sodium-glucose cotransporter inhibitors (SGLT2Is) have been the subject of relatively few investigations in individuals with heart failure (HF) who do not have diabetes. As a result, researchers performed a meta-analysis to learn more about SGLT2I’s impact on HF patients with and without diabetes. Researchers looked for this information in PubMed, Scopus, Web of Science, and Embase.

Patients with HF were included in all clinical trials that assessed the effectiveness of SGLT2Is to placebo. To analyze the dichotomous data, we used RevMan 5.3 for Windows, and the Mantel-Haenszel technique. About 13 randomized clinical trials with a total of 75,287 individuals were included in the study. Patients with (relative risk (RR)=0.68, 95% CI 0.63 to 0.74) and without diabetes (RR=0.75, 95% CI 0.62 to 0.89) saw substantial reductions in their risk of hospitalization due to HF when treated with SGLT2Is. There was a statistically significant reduction in mortality risk among patients with diabetes (RR=0.87, 95% CI 0.77 to 0.99) and patients without diabetes (RR=0.93, 95% CI 0.70 to 1.23), but there was no such reduction among patients without diabetes.

Patients with diabetes (RR=0.94, 95% CI 0.90 to 0.98) and those without diabetes (RR=0.72, 95% CI 0.38 to 1.39) had a significantly reduced risk of major adverse events when treated with SGLT2I. SGLT2Is significantly decreased cardiovascular mortality, HHF, and major adverse events in people with diabetes. However, although showing a significant reduction in HHF, SGLT2I reduced cardiovascular mortality or major adverse events without statistical significance in patients.

Source: sciencedirect.com/science/article/abs/pii/S0002914922011146