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Association Between SGLT2is and Cardiovascular and Respiratory Diseases: A Meta-Analysis of Large Trials

Dao-Gen Yin1, Mei Qiu2, Xue-Yan Duan1

  • 1Center of Community Health Service Management, Shenzhen Longhua District Central Hospital, Shenzhen, China.

Frontiers in Pharmacology
|August 12, 2021
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) show reduced risks for cardiovascular and respiratory diseases. This meta-analysis found SGLT2is significantly lower risks for conditions like atrial fibrillation and COPD.

Area of Science:

  • Cardiology
  • Pulmonology
  • Pharmacology

Background:

  • The cardiovascular and respiratory benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2is) are not fully established.
  • Existing research has not comprehensively evaluated SGLT2is across a wide spectrum of cardiovascular and respiratory conditions.

Purpose of the Study:

  • To investigate the association between SGLT2 inhibitor use and the incidence of 80 cardiovascular diseases and 55 respiratory diseases.
  • To synthesize evidence from large randomized trials to quantify the risk reduction associated with SGLT2is.

Main Methods:

  • A meta-analysis of nine large randomized controlled trials involving SGLT2 inhibitors.
  • Risk ratios (RR) and 95% confidence intervals (CI) were calculated to assess the association between SGLT2is and various disease outcomes.
  • Both random-effects and fixed-effects models were employed, with heterogeneity and publication bias assessed.

Main Results:

  • SGLT2 inhibitors were associated with significantly reduced risks for 9 cardiovascular diseases, including atrial fibrillation (RR 0.78, 95% CI 0.67-0.91), bradycardia (RR 0.60, 95% CI 0.40-0.89), and hypertensive emergency (RR 0.29, 95% CI 0.12-0.72).
  • SGLT2 inhibitors also showed reduced risks for 11 respiratory diseases, such as chronic obstructive pulmonary disease (RR 0.77, 95% CI 0.61-0.97), asthma (RR 0.57, 95% CI 0.35-0.95), and sleep apnoea syndrome (RR 0.36, 95% CI 0.15-0.87).
  • No significant associations were found for the remaining 115 cardiovascular and respiratory diseases, with minimal heterogeneity and publication bias observed.

Conclusions:

  • SGLT2 inhibitors demonstrate a significant risk reduction for specific cardiovascular and respiratory conditions.
  • These findings suggest a potential role for SGLT2 inhibitors in the primary and secondary prevention of these diseases.
  • Further research may elucidate the mechanisms underlying these protective effects.
Keywords:
SGLT2isasthmaatrial fibrillationbradycardiachronic obstructive pulmonary diseasehypertensive emergencysleep apnoea syndrome

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