Effects of SGLT2 inhibitors on cardiovascular outcomes and mortality in type 2 diabetes: A meta-analysis

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Cai-Yan Zou1, Xue-Kui Liu1, Yi-Quan Sang1

  • 1Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University.

Medicine
|December 6, 2019
PubMed
Abstract

Insights

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors significantly reduce major adverse cardiovascular events, myocardial infarction, and mortality in type 2 diabetes patients. However, they do not decrease the risk of ischemic stroke.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Optimal glycemic control is crucial for preventing cardiovascular events in type 2 diabetes.
  • The cardiovascular and mortality benefits of sodium-glucose cotransporter-2 (SGLT-2) inhibitors are not fully established.
  • This meta-analysis evaluates the impact of SGLT-2 inhibitors on cardiovascular outcomes and mortality in type 2 diabetes patients.

Purpose of the Study:

  • To assess the effects of SGLT-2 inhibitors on cardiovascular events and mortality.
  • To synthesize evidence from randomized controlled trials (RCTs) involving SGLT-2 inhibitors.
  • To determine the class-wide impact of SGLT-2 inhibitors on major adverse cardiovascular events and mortality.

Main Methods:

  • Systematic literature search of Medline, Embase, and Cochrane Library.
  • Inclusion of RCTs evaluating canagliflozin, dapagliflozin, and empagliflozin.
  • Analysis of SGLT-2 inhibitor monotherapy or add-on therapy with other antidiabetic agents.

Main Results:

  • Analysis of 42 trials with 61,076 patients with type 2 diabetes.
  • SGLT-2 inhibitors significantly reduced major adverse cardiovascular events (MACEs), myocardial infarction, cardiovascular mortality, and all-cause mortality.
  • No significant reduction in the risk of ischemic stroke was observed with SGLT-2 inhibitor treatment.

Conclusions:

  • SGLT-2 inhibitors, as a class, demonstrate a decreased risk of cardiovascular events and mortality.
  • These findings support the use of SGLT-2 inhibitors for cardiovascular risk reduction in type 2 diabetes.
  • Further research may be needed to explore the specific effects on cerebrovascular events like ischemic stroke.

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