The impact of SGLT2 inhibitors on cardiac remodeling after myocardial infarction: an updated meta-analysis of randomized controlled trials
Abstract
Background: Recent studies show that sodium-glucose linked transporter 2 inhibitors (SGLT2is) reduce blood glucose and provide cardiovascular benefits, decreasing acute myocardial ischemia/reperfusion injury in patients with acute myocardial infarction (AMI).
Objective: This meta-analysis aims to thoroughly assess the clinical effectiveness of SGLT2is in the treatment of AMI.
Methods: Randomized controlled trials (RCTs) evaluating the efficacy of SGLT2is in combination with guideline-directed medical therapy (GDMT) for AMI were retrieved from major databases: PubMed, Cochrane Library, Embase, Medline, and Web of Science. At the same time, clinical trial registries (ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform) were searched, covering all published literature up to May 2025. Using the Cochrane Collaboration for assessing the risk of bias, two independent reviewers preliminarily screened and assessed the studies according to the preset inclusion criteria. Meta-analysis was conducted using RevMan 5.4 software, and StataMP 16.0 was used to evaluate publication bias. The quality of evidence was graded according to recommended procedures for assessing and evaluating the evidence.
Results: Five RCTs with a total of 881 patients were included in this analysis. According to a meta-analysis, SGLT2is and GDMT significantly reduced NT-proBNP (RR = -89.82, 95% CI -96.28 to -83.35; p 40% group (MD = 5.20, 95% CI 2.74 to 7.66; p 40% group showed a…
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: 881 participants or records.
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