Sodium-Glucose Co-transporter 2 Inhibitors and Cardiovascular Event Reduction in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis
Abstract
Background: Heart failure with preserved ejection fraction (HFpEF) is a prevalent and challenging cardiovascular condition associated with high morbidity and mortality. Despite the lack of effective pharmacological treatments, recent studies have suggested that sodium-glucose co-transporter 2 inhibitors (SGLT2Is) may offer potential benefits in reducing cardiovascular events in HFpEF patients. The aim of this systematic review and meta-analysis is to assess the efficacy of SGLT2Is in reducing cardiovascular outcomes in individuals with HFpEF.
Methods: A comprehensive literature search was conducted across PubMed, Cochrane Library, Embase, and clinical trial registries for studies published up to October 2024. Randomised controlled trials (RCTs) that investigated the use of SGLT2Is in patients with HFpEF and reported on major cardiovascular outcomes were included. Data from eligible studies were pooled to calculate risk ratios (RR) and 95% CIs for the primary outcomes, including major adverse cardiovascular events (MACE) and hospitalisation for heart failure (HHF).
Results: Fifteen RCTs involving 12,436 patients with HFpEF were included in the meta-analysis. Treatment with SGLT2Is reduced the risk of MACE (RR=0.79, 95% CI [0.70-0.89]) and HHF (RR=0.72, 95% CI [0.65-0.87]) compared with placebo. Secondary analyses demonstrated reductions in cardiovascular mortality (RR=0.84, 95% CI [0.75-0.95]) and improvements in health-related quality of life as assessed by Kansas City…
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: 12,436 participants or records.
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