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- Akash Jaiswal, Vikash Jaiswal, Song Peng Ang, Muhammad Hanif, Ananya Vadhera, Vibhor Agrawal, Tushar Kumar, Anagha M Nair, VamsikalyanReddy Borra, Vamsi Garimella, Angela Ishak, Zarghoona Wajid, David Song, Abdelrahman M Attia, Helen Huang, Victor Hugo Aguilera Alvarez, Abhigan Babu Shrestha, and Monodeep Biswas.
- Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India.
- Medicine (Baltimore). 2023 Sep 29; 102 (39): e34693e34693.
BackgroundSodium-glucose co-transporter 2 (SGLT2) inhibitors have been recommended in the practice guidelines for the treatment of patients with heart failure with reduced ejection fraction; however, their effects among patients with preserved ejection fraction have been debatable.ObjectiveWe aim to evaluate the SGLT2 inhibitor effect among patients with heart failure with reduced ejection fraction, including DELIVER and EMPEROR-Preserved trials.MethodsWe performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until August 30th, 2022. Statistical analysis was performed by calculating hazard ratio (HR) using the random effect model with a 95% confidence interval (CI) and probability value (P). Statistical significance was met if 95% CI does not cross numeric "1" and P < .05.ResultsSix studies with a total of 15,989 total patients were included in the final analysis. The mean age of patients enrolled in SGLT2 inhibitors and placebo was 69.13 and 69.37 years, respectively. The median follow-up duration was 2.24 years. SGLT2 inhibitors reduced composite cardiovascular mortality or first hospitalization for heart failure (HR, 0.80 [95% CI: 0.74-0.87], P < .001, I2 = 0%), heart failure hospitalization (HR, 0.74 [95% CI: 0.67-0.82], P < .001, I2 = 0%) compared with placebo. However, all-cause mortality (HR, 0.97 [95% CI: 0.89-1.06], P = .54, I2 = 0%) and cardiovascular mortality (HR, 0.96 [95% CI: 0.82-1.13), P = .66, I2 = 35.09%] were comparable between both groups.ConclusionOur study finding shows that SGLT2 inhibitors significantly reduced the risk of first HF hospitalization or cardiovascular death and HF hospitalization; however, all-cause mortality was comparable between the groups.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
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