Efficacy of SGLT2 Inhibitors in Reducing Cardiovascular Mortality in Heart Failure Patients: A Meta-Analysis

Author(s): Abdul Rahman Mohamed Elmohamed, Abdullah Almazouni, Shijas Shanavas, Muhammed Ajas, Roohiba Abdul Wahab, Saad Mohammed, Aliasgar Taha, Muhammad Umair , Ayah Mohtaz Shams Basha , Muhammad Salman Arif

Heart failure (HF) remains one of the leading causes of mortality worldwide, even with the advent of new medications and surgical techniques. Sodium-glucose cotransporter-2 (SGLT2) antagonists were first created to treat obesity, but they also shown significant advantages for heart wellness. The purpose of this meta-analysis is to ascertain if SGLT2 inhibiting agents, independent of ejection fractions and the disease, are useful in reducing cardiovascular death in HF patients. A meta-analysis and thorough review were conducted using data from RCTs on ClinicalTrials.gov, PubMed, the Encyclopedia Cochrane, and Embase. The inclusion criteria encompassed studies that reported the concentration of cardiovascular-related deaths as one of the primary or secondary endpoints among HF patients using SGLT2 inhibitors. Pooled estimates, including pooled hazard ratios (HRs), subgroup analyses, and heterogeneity analyses (I² statistic, Q-test), were computed using models with both constant and fixed consequences. A response study was conducted to investigate the impact of study quality and other biases on the results. The meta-analysis focused on numerous RCTs with a large sample size. Pooled analyses showed The heart attack probability ratio was 0.78 (95% CI: 0.72 – 0.84, p <0.001), which indicates a 22% decrease in risk. Even while the significance level among individuals with HFpEF was in excess of 0.05, the difference was still substantial (HR: 0.82, p < 0.01), and the SGLT2 blockers also shown positive outcomes in HFrEF participants (HR: 0.76, p < 0.001). Patients who have persistent kidney dysfunction (HR: 0.79, p < 0.01) and diabetes (HR: 0.74, p < 0.001) showed a greater decreased risk of cardiovascular mortality than their non-diabetic and non-CKD counterparts. The latter results were robust to sensitivity analyses, confirming that these findings were consistent despite certain study heterogeneities (I² = 38%). Patients diagnosed with heart failure (HF), regardless of whether they are diabetic or not, are protected from cardiovascular death with the custom of SGLT2 inhibitors. Because of all these patients' needs, alongside traditional HF medications should be added as an additional cornerstone for the management of HF due to their excellent efficacy, safety and renal benefits.