The Effect of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors on Cardiovascular Outcomes in Cancer Patients With Type 2 Diabetes Mellitus: A Systematic Review
Abstract
While the cardiovascular benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with type 2 diabetes mellitus (T2DM) are well-established, their role in cancer patients with T2DM - a population at heightened risk of cardiovascular complications due to both malignancy and cardiotoxic therapies - remains unclear. This systematic review aimed to synthesize the existing evidence on the effects of SGLT2is on cardiovascular outcomes in this high-risk group. We conducted a comprehensive literature search across PubMed/MEDLINE, Embase, Scopus, and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Observational cohort studies and randomized controlled trials (RCTs) evaluating SGLT2is in adult cancer patients with T2DM were included. Data extraction and quality assessment (using the Newcastle-Ottawa Scale for cohort studies) were performed independently by two reviewers. Due to clinical and methodological heterogeneity, findings were synthesized narratively, with effect estimates [hazard ratios (HRs), odds ratios (ORs)] and 95% confidence intervals (CIs) reported. Nine studies (n = 162,605 participants) were included, comprising retrospective cohorts (n = 7) and population-based studies (n = 2). SGLT2i use was consistently associated with reduced all-cause mortality and heart failure (HF)-related hospitalizations. Benefits were particularly pronounced in patients exposed to anthracyclines or…
How strong is the evidence?
Evidence Hub reads this as a systematic review, 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: 162,605 participants or records.
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