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Effects of sodium-glucose cotransporter 2 inhibitors on cardiomyopathy: a meta-analysis

Xu B, Zhang T, Zhou J

Journal of endocrinological investigation, 2025

97,035 participants · 1 citation

Abstract

BACKGROUND: Cardiomyopathies can present at any age and affect individuals and families across the entire life course. Clinical effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on cardiomyopathy have not yet been fully elucidated.

OBJECTIVE: The primary objective of this study was to investigate whether SGLT2 inhibitors have an effect on cardiomyopathy compared to placebo.

METHODS: We systematically searched for randomized double-blind placebo-controlled trials on PubMed, Web of Science, EU Clinical Trials Register, and ClinicalTrials.gov. We used the Mantel-Haenszel statistical method, fixed-effects model and risk ratio (RR) with 95% confidence intervals (CI) to analyze binary data.

RESULTS: A total of 19 studies were included, covering 97,035 participants. Compared to placebo, SGLT2 inhibitors were associated with a reduced risk of cardiomyopathy (RR 0.72; 95% CI 0.56-0.92; P < 0.01; high certainty of evidence), with non-significant heterogeneity (Pheterogeneity=0.81; I2 = 0%), especially observed in the empagliflozin subgroup (RR 0.66; 95% CI 0.46-0.94; P = 0.02), chronic kidney disease (RR 0.67; 95% CI 0.47-0.97; P = 0.03) population and heart failure (RR 0.46; 95% CI 0.23-0.91; P = 0.03) population. However, in type 2 diabetes mellitus population, the effect of SGLT2 inhibitors on cardiomyopathy incidence was less clear (RR 0.76; 95% CI 0.51-1.12; P = 0.17; moderate certainty of evidence). Additionally, SGLT2 inhibitors were associated with a reduced risk of…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 97,035 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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