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Association of SGLT2is with cardiovascular and reproductive diseases: a meta-analysis based on 14 large-scale

Lei Li1,2,3, Yun-Hua Dong1,2,3, Yun Bai1,2,3

  • 1Department of Reproductive Medicine, The First People's Hospital of Yunnan Province, Kunming, Yunnan Province, China.

Endocrine
|November 29, 2023
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) show significant benefits in reducing cardiovascular diseases like heart failure and hypertension. This meta-analysis confirms their safety for the reproductive system, with no significant risks identified.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are established to improve cardio-renal outcomes in patients with diabetes, heart failure (HF), and renal failure.
  • The cardiovascular and reproductive safety profiles of SGLT2is warrant further investigation across a broad range of conditions.

Purpose of the Study:

  • To investigate the association between SGLT2 inhibitors and the risks of various cardiovascular and reproductive diseases.
  • To synthesize evidence from large-scale randomized trials to assess the safety and efficacy of SGLT2is.

Main Methods:

  • A meta-analysis was conducted on 14 large randomized trials, including over 1000 participants each.
  • Outcomes assessed included serious adverse events related to cardiovascular and reproductive diseases.
  • Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated to determine associations.

Main Results:

  • SGLT2is were associated with significantly lower risks for 13 cardiovascular diseases, including chronic heart failure (RR 0.70), congestive heart failure (RR 0.74), acute heart failure (RR 0.72), coronary artery disease (RR 0.75), ischemic cardiomyopathy (RR 0.72), atrial fibrillation (RR 0.88), bradycardia (RR 0.72), and hypertension (RR 0.70).
  • No significant associations were found between SGLT2is and 18 types of reproductive diseases, such as adenomyosis, endometrial hyperplasia, and metrorrhagia.
  • A potential increased risk of uterine prolapse was observed, but with a wide confidence interval.

Conclusions:

  • This meta-analysis reaffirms the benefits of SGLT2 inhibitors in managing chronic congestive heart failure.
  • Evidence suggests potential benefits of SGLT2 inhibitors in reducing risks of acute heart failure, myocardial infarction, arrhythmias, and hypertension.
  • SGLT2 inhibitors demonstrate a generally safe profile concerning the reproductive system.
Keywords:
Atrial fibrillationCoronary artery diseaseHeart failureHypertensionReproductive diseasesSGLT2is

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