Daily Dose: HF, CV Benefit of SGLT-2 Inhibition Consistent in T2D, CDK, HF

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week we reported on a study published in the Journal of the American College of Cardiology that examined the effects of SGLT2 inhibitors on heart failure (HF) outcomes and cardiovascular (CV) death across different patient populations.

The study

Authors of the systematic review and meta-analysis searched the Medline, Scopus, and Cochrane Central databases from inception through November 2022 for analyses, either primary or secondary, of randomized controlled trials (RCTs) that compared SGLT2 inhibitor therapy with placebo in patients with HF, T2D, CKD, or any combination. Outcomes of primary interest were a composite of first HF hospitalization or CV death, first HF hospitalization, or CV mortality.

A final group of 13 trials met eligibility criteria comprising data from 90 413 participants. Of the total, 48 485 individuals received SGLT2 inhibitors and 41 928 received placebo.

The findings

Results of the analysis showed SGLT2 inhibitors, compared with placebo, reduced the risk of first HFF and/or CV death by 24% in HF, 23% in T2D, and 23% in CKD.

Researchers reported a consistent benefit of SGLT-2 therapy in patients with HF with reduced or preserved ejection fraction, those with HF both with and without T2D, and in patients with HF with or without CKD. In patients with T2D, they reported consistent benefits in those with or without CKD and in those without HF, as well as in patients with CKD without HF. The benefit was seen in participants with all 3 conditions.

Addressing the question about the effect of SGLT-2 inhibitor therapy specifically on CV mortality, the researchers reported a significant reduction in CV death of 16% in patients with HF, 15% in those with T2D, and 12% in those with CKD.

A note from authors

“These findings support a ‘call to action’ for the widespread adoption of the use of SGLT2 inhibitors across all 3 patient populations.”

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