European Primary Care Cardiovascular Society

Consistent benefit of SGLT2 inhibitors on CV outcomes across various patient populations

Effect of SGLT2 Inhibitors on Cardiovascular Outcomes Across Various Patient Populations

Literature - Usman MS, Siddiqi TJ, Anker SD, et al. - J Am Coll Cardiol. 2023 Jun 27;81(25):2377-2387. doi: 10.1016/j.jacc.2023.04.034

Introduction and methods


SGLT2 inhibitors have been studied in various large-scale clinical trials in patients with T2D, HF and CKD [1-12]. The effects of SGLT2 inhibitors on HF outcomes and CV mortality in patient populations with multiple comorbidities of T2D, HF and CKD remain uncertain.

Aim of the study

The authors investigated the effect of SGLT2 inhibitors on CV outcomes in subgroups of patients with various combinations of cardiovascular, kidney, and metabolic comorbidity.



A systematic review was performed of literature published in Medline, Scopus and Cochrane Central databases up to the last week of November 2022. In this meta-analysis, primary or secondary analyses of placebo-controlled RCTs with SGLT2 inhibitors were included when they had at least 1000 participants and were reporting on the composite of first HF hospitalization or CV mortality, first HF hospitalization, or CV mortality. A total of 13 studies (n=90,413 participants) were included. Data were analyzed in 12 different patients populations with different combinations of HF, T2D, and CKD.

Main results

Composite of first HF hospitalization or CV mortality

First HF hospitalization

CV mortality


This meta-analysis demonstrated that SGLT2 inhibitors reduce the risk of the composite of HF hospitalizations or CV mortality in patients with HF, T2D, or CKD, and with varying combinations of HF, T2D and CKD. Consistent findings were observed when analyzing first HF hospitalization and CV mortality separately, but the effect of SGLT2 inhibitors on CV mortality was more modest. “These findings support a “call to action” for the widespread adoption of the use of SGLT2 inhibitors across all 3 patient populations.’’, according to the authors.


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Find this article online at J Am Coll Cardiol.

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