SGLT2 inhibitors and risk reduction for mortality in high-risk patients: a meta-analysis of randomized controlled trials
Abstract
Background: The aim of this paper is to assess the impact of sodium-glucose cotransporters-2 (SGLT2) inhibitors on all-cause and cardiovascular (CV) death in high-risk patients and compare the efficacy of empagliflozin and dapagliflozin. Methods: PubMed was queried from inception to the last week of September 2023 for randomized controlled trials that compared SGLT2 inhibitors’ empagliflozin or dapagliflozin with placebo and included patients with heart failure (HF), type 2 diabetes mellitus (T2DM), or chronic kidney disease (CKD). The outcome of interest was CV death or all-cause death. Hazard ratios (HR) with 95% confidence intervals (CI) were pooled using a random effect model, and forest plots were created to analyze the results visually. A chi-square test was performed to assess subgroup differences between empagliflozin and dapagliflozin. Results: Eight trials (N=55,818) were included in our analysis, namely EMPA-REG, EMPEROR-Reduced, EMPEROR-Preserved, EMPA-KIDNEY, DECLARE-TIMI, DAPA-HF, DELIVER and DAPA-CKD. Pooled analysis demonstrated that compared to placebo, SGLT2 inhibition reduced the risk of CV death (SGLT2i arm = 1405 events, 29,089 total patients; placebo arm = 1515 events, 26,729 total patients; HR: 0.85; 95%CI: 0.79-0.93, p<0.001) and all-cause death (SGLT2i arm = 2,491 events, 29,062 total patients; placebo arm= 2,625 events, 26,729 total patients; HR: 0.86; 95% CI 0.79-0.95, p=0.002) in high-risk patients identified as having either T2DM, HF, or CKD. No…
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: 55,818 participants or records.
Read the paper
Related studies
- Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa
- Global and regional estimates of genital human papillomavirus prevalence among men: a systematic review and meta-analysis
- A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: The TRACTS longitudinal prospective cohort study
- Post‑COVID‑19 Syndrome in Outpatients: a Cohort Study
- Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients
- Electroacupuncture for Painful Diabetic Peripheral Neuropathy: A Multicenter, Randomized, Assessor-Blinded, Controlled Trial
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.