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SGLT2 inhibitors reduce sudden cardiac death risk in heart failure: Meta-analysis of randomized clinical trials

Connor P Oates1, Carlos G Santos-Gallego2, Alex Smith1

  • 1MedStar Heart and Vascular Institute, Georgetown University-Washington Hospital Center, Washington, District of Columbia, USA.

Journal of Cardiovascular Electrophysiology
|March 23, 2023
PubMed

Insights

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce sudden cardiac death risk in heart failure patients. This finding supports SGLT2i use in heart failure management, though further research on arrhythmias is needed.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are established to reduce cardiovascular death and heart failure hospitalizations.
  • The specific impact of SGLT2i on sudden cardiac death (SCD) in heart failure patients remains uncertain.

Purpose of the Study:

  • To evaluate the effect of SGLT2 inhibitors on the risk of sudden cardiac death in patients with heart failure.

Main Methods:

  • A systematic search identified randomized controlled trials comparing SGLT2i with placebo in heart failure patients.
  • Data from eleven trials, including 10,796 patients on SGLT2i and 10,796 on placebo, were analyzed for outcomes including SCD and arrhythmias.

Main Results:

  • SGLT2i therapy significantly reduced the risk of sudden cardiac death (RR: 0.68; 95% CI: 0.48-0.95; p=0.03).
  • No significant differences were observed in sustained ventricular arrhythmias (RR: 1.03; 95% CI: 0.83-1.29) or atrial arrhythmias (RR: 0.91; 95% CI: 0.77-1.09) between groups.

Conclusions:

  • SGLT2 inhibitors are associated with a decreased risk of sudden cardiac death in heart failure patients on contemporary medical therapy.
  • Further prospective trials are necessary to elucidate the long-term effects of SGLT2i on atrial and ventricular arrhythmias.
Abstract

Keywords:
SGLT2 inhibitorheart failuresudden cardiac death

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