SGLT-2 inhibitors and cardiovascular outcomes in patients with and without a history of heart failure: a systematic review and meta-analysis
Abstract
Aims Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have cardiovascular (CV) benefits in patients with heart failure with reduced ejection fraction (HFrEF). Whether these medications improve CV outcomes irrespective of heart failure history or left ventricular ejection fraction (LVEF) in HFrEF remains unknown. Methods and results All randomized, placebo-controlled trials of SGLT-2 inhibitors reporting similar CV outcomes were searched in PubMed from 1 January 2010 to 1 October 2021. The primary outcome was the composite of hospitalization for heart failure or CV death. Secondary outcomes included all-cause mortality. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used as effect estimates and calculated with a random-effects model. Data from 11 trials and a total of 66 957 patients (n = 36 758 SGLT-2 group, n = 30 199 placebo group) were included. SGLT-2 inhibitors reduced the risk of hospitalization for heart failure or CV death in patients with (HR 0.76, 95% CI 0.71-0.80) and without (HR 0.76, 95% CI 0.68-0.86; Pinteraction = 0.69) heart failure. Patients with (HR 0.87, 95% CI 0.80-0.95) and without (HR 0.84, 95% CI 0.73-0.95; Pinteraction = 0.67) heart failure treated with SGLT-2 inhibitors had a reduction in all-cause mortality. Reduction in the primary outcome was consistently observed in HFrEF patients with (HR 0.68, 95% CI 0.59-0.78) and without (HR 0.84, 95% CI 0.71-0.99; Pinteraction = 0.13) severely reduced LVEF, and in heart failure with pres…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Direct evidence supporting initiation of an SGLT2 inhibitor for patients with T2D and eGFR 20-29 mL/min/1.73 m2 is strongest for patients with concomitant albuminuria or heart failure, though efficacy and safety are generally consistent among trial participants with or without these conditions.
“Based on these results, direct evidence supporting initiation of an SGLT2i for patients with T2D and eGFR 20–29 mL/min/1.73 m2 is strongest for patients with concomitant albuminuria or HF, though the efficacy and safety of SGLT2i are generally consistent among trial participants with or without these conditions (56,61,62).”
No citation lists for this paper
No citation lists for this paper yet — checked again daily.
References 32 · Cited by 41
- Authors
- Razuk, V., Chiarito, M., Cao, D., Nicolas, J., Pivato, C. A., Camaj, A., Power, D., Beerkens, F., Jones, D., Alter, A., Mathew, A., Spirito, A., Contreras, J. P., Dangas, G. D., & Mehran, R.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- IRCCS Humanitas Research Hospital (IT)
- Corresponding author
- Mehran, Roxana
- ORCID
- Venue
- European Heart Journal - Cardiovascular Pharmacotherapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-01-11
- Volume
- 8
- Issue
- 6
- Pages
- 557-567
- ISSN
- 2055-6837 (ISSN-L)
- 2055-6845
- OpenAlex
- W4205831060
- Cited by
- 41
- References
- 32
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 7 · 2023: 13 · 2022: 6
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- European Heart Journal - Cardiovascular Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- SGLT2 inhibitors, heart failure with reduced ejection fraction, heart failure with preserved ejection fraction, cardiovascular outcomes, heart failure hospitalization, cardiovascular mortality, all-cause mortality, left ventricular ejection fraction, cardiorenal protection
- MeSH terms
- Sodium-Glucose Transporter 2 Inhibitors, Cardiovascular System, Heart Failure, Humans, Stroke Volume, Ventricular Function, Left
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
