JAMA Netw Open: Association of sodium-glucose cotransporter 2 inhibitors with cardiovascular outcomes and other cardiovascular disease risk factors in patients with type 2 diabetes mellitus

Background: When sodium-glucose cotransporter 2 inhibitors (SGLT2-IS) are introduced as standard of care, cardiovascular outcomes in selected populations are unclear

Data sources: Searches of electronic databases PubMed, Google Scholar, Web of Science, and Cochrane, from inception to January 10, 2021, identified additional studies through conference papers and conference presentations, ClinicalTrials.

DATA SELECTION: This study included placebo-controlled randomized clinical trials with participants with atherosclerotic cardiovascular disease (ASCVD) or risk factors for ASCVD, diabetes, or heart failure, and reported the primary outcome

Data extraction and synthesis: Medical subject search terms included SGLT2-I and multiple cardiovascular results in different combinations

Main Outcomes and Measures: Six efficacy outcomes using SGLT2-I (cardiovascular death and heart failure hospitalization as primary outcomes, major adverse cardiovascular events, heart failure, cardiovascular death, acute myocardial infarction, and all-cause death as secondary outcomes ) to evaluate

RESULTS: Ten studies were included with 71,553 participants, 39,053 of whom received SGLT2-IS, and 28,809 men and 15,655 women (mean age, 65.

Subgroup analysis by sex and age

Subgroup Analysis by Ethnicity

Conclusions: This meta-analysis supports that SGLT2-IS has emerged as an effective drug class for improving cardiovascular morbidity and mortality in selected patients

Bhattarai M, Salih M, Regmi M, et al.