The Role of SGLT2 Inhibitors on Heart Failure Outcomes in Nondiabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Link to article at PubMed

J Cardiovasc Pharmacol. 2023 Nov 15. doi: 10.1097/FJC.0000000000001511. Online ahead of print.


Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve cardiovascular outcomes in patients with heart failure (HF). However, studies examining their benefits exclusively in nondiabetic patients on various HF outcomes are limited. By conducting a MEDLINE and search for randomized controlled trials, we identified four studies on SGLT2i with data on HF outcomes in nondiabetic patients and performed a meta-analysis. 5316 patients in the SGLT2i group and 5322 in the placebo group were included in this meta-analysis. The composite of worsening HF (hospitalization for HF, urgent visit for HF) or cardiovascular death had 726 events (13.66%) in the SGLT2i group and 907 (17.04%) in the placebo group, with a hazard ratio (HR) of 0.78, 95% confidence interval (CI) of 0.71 to 0.86 (p<0.0001). There were 551 events (10.36%) of hospitalization for HF in the SGLT2i group, compared to 751 (14.11%) in the placebo group with an HR of 0.71, 95% CI of 0.62 to 0.81 (p<0.0001). Cardiovascular death occurred in 396 patients (7.45%) in the SGLT2i group, 452 (8.49%) in the placebo group, with an HR of 0.88, 95% CI of 0.77 to 1.00 (p=0.059). All-cause mortality occurred in 552 patients (10.38%) in the SGLT2i group and 586 (11.01%) in the placebo group with an HR of 0.95 and a 95% CI of 0.84 to 1.07 (p=0.37). This study showed that in patients with HF without diabetes mellitus, SGLT2i improve HF outcomes, including a significant decrease in hospitalizations for HF and a favorable response for the outcome of cardiovascular death.

PMID:37989136 | DOI:10.1097/FJC.0000000000001511

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