Impact of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) on Cardiovascular Outcomes in Heart Failure With Reduced Ejection Fraction Under Contemporary Standard Care: A Systematic Review and Meta-Analysis
Abstract
This systematic literature review and meta-analysis evaluates the efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in reducing key cardiovascular outcomes, namely hospitalization for heart failure, cardiovascular mortality, and all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). A total of 12 publications (including subgroup analyses) were analyzed. The selected RCTs compared the effects of SGLT2i (empagliflozin, dapagliflozin, and canagliflozin) with standard care among patients with HFrEF. The pooled data demonstrated that SGLT2i significantly reduced the risk of cardiovascular mortality by 23% and hospitalization for heart failure by 25%, compared to standard care. These benefits were consistently observed across both diabetic and non-diabetic subgroups, underscoring the broader therapeutic potential of SGLT2i in HFrEF management. However, no statistically significant reduction in all-cause mortality was identified. While the findings affirm the cardioprotective effects of SGLT2i, the lack of impact on overall mortality highlights the need for further longitudinal studies. These results support the integration of SGLT2i into contemporary HFrEF treatment protocols while informing future research priorities.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Strategy for Mitigating DKA Risk in Patients with Type 1 Diabetes on Adjunctive Treatment with SGLT Inhibitors: A STICH Protocol
- Glucoraphanin: a broccoli sprout extract that ameliorates obesity-induced inflammation and insulin resistance
- SGLT2 Inhibitors in Heart Failure: Targeted Metabolomics and Energetic Metabolism
- Mechanisms of blood pressure reduction with sodium-glucose co-transporter 2 (SGLT2) inhibitors
- Sodium-glucose cotransporter inhibitors: beyond glycaemic control
- Decoding the effects of SGLT2 inhibitors on cardiac arrhythmias in heart failure
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.