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The Role of SGLT2 Inhibitors in Heart Failure: A Systematic Review and Meta-Analysis

Vasiliki Tsampasian1, Ranu Baral1, Rahul Chattopadhyay2,3

  • 1Department of Cardiology, Norfolk and Norwich University Hospitals, Norwich, UK.

Cardiology Research and Practice
|August 30, 2021
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors significantly reduce mortality and hospitalizations for heart failure (HF) in patients with or without diabetes. This meta-analysis confirms their favorable cardiovascular profile in HF patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular benefits in patients with diabetes.
  • Heart failure (HF) is a major cause of morbidity and mortality worldwide.
  • The role of SGLT2 inhibitors in HF patients, irrespective of diabetes status, requires comprehensive evaluation.

Purpose of the Study:

  • To systematically review and meta-analyze existing evidence on the efficacy of SGLT2 inhibitors in patients with heart failure.
  • To evaluate the impact of SGLT2 inhibitors on cardiovascular outcomes and mortality in HF patients, considering their diabetes status.

Main Methods:

  • A systematic literature search was conducted across PubMed, Web of Science, and Cochrane Library databases until November 20, 2020.
  • Eight randomized controlled trials (RCTs) involving 13,275 patients were included in the meta-analysis.
  • Outcomes assessed included all-cause mortality, hospitalization for HF, cardiovascular death, and composite endpoints.

Main Results:

  • SGLT2 inhibitors significantly reduced all-cause mortality (HR: 0.83), hospitalization for HF (HR: 0.68), cardiovascular death (HR: 0.82), and a composite of HF hospitalization or CV death (HR: 0.72) in the overall population.
  • Subgroup analyses confirmed these benefits regardless of baseline diabetes status.
  • All observed effects showed high statistical significance with no heterogeneity (I² = 0%).

Conclusions:

  • This meta-analysis confirms the favorable cardiovascular profile of SGLT2 inhibitors in patients with heart failure.
  • These benefits extend to patients regardless of their baseline diabetes status.
  • SGLT2 inhibitors represent a significant therapeutic advancement for managing heart failure.

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