000			05200nam a22006017a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a2213-8587
024			_aS2213-8587(24)00102-5 [pii]
040			_aOvid MEDLINE(R)
099			_a38768620
245			_aEffect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis.
251			_aThe Lancet Diabetes & Endocrinology. 12(7):447-461, 2024 Jul.
252			_aLancet Diabetes Endocrinol. 12(7):447-461, 2024 Jul.
253			_aThe lancet. Diabetes & endocrinology
260			_c2024
260			_fFY2024
260			_p2024 Jul
265			_sppublish
265			_tMEDLINE
266			_d2024-08-07
266			_z2024/05/20 18:53
520			_aBACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors have been studied in patients with heart failure, type 2 diabetes, chronic kidney disease, atherosclerotic cardiovascular disease, and acute myocardial infarction. Individual trials were powered to study composite outcomes in one disease state. We aimed to evaluate the treatment effect of SGLT2 inhibitors on specific clinical endpoints across multiple demographic and disease subgroups.
520			_aFINDINGS: We included 15 trials (N=100 952). Compared with placebo, SGLT2 inhibitors reduced the risk of first hospitalisation for heart failure by 29% in patients with heart failure (hazard ratio [HR] 0.71 [95% CI 0.67-0.77]), 28% in patients with type 2 diabetes (0.72 [0.67-0.77]), 32% in patients with chronic kidney disease (0.68 [0.61-0.77]), and 28% in patients with atherosclerotic cardiovascular disease (0.72 [0.66-0.79]). SGLT2 inhibitors reduced cardiovascular death by 14% in patients with heart failure (HR 0.86 [95% CI 0.79-0.93]), 15% in patients with type 2 diabetes (0.85 [0.79-0.91]), 11% in patients with chronic kidney disease (0.89 [0.82-0.96]), and 13% in patients with atherosclerotic cardiovascular disease (0.87 [0.78-0.97]). The benefit of SGLT2 inhibitors on both first hospitalisation for heart failure and cardiovascular death was consistent across the majority of the 51 subgroups studied. Notable exceptions included acute myocardial infarction (22% reduction in first hospitalisation for heart failure; no effect on cardiovascular death) and heart failure with preserved ejection fraction (26% reduction in first hospitalisation for heart failure; no effect on cardiovascular death).
520			_aFUNDING: None. Copyright © 2024 Published by Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.
520			_aINTERPRETATION: SGLT2 inhibitors reduced heart failure events and cardiovascular death in patients with heart failure, type 2 diabetes, chronic kidney disease, and atherosclerotic cardiovascular disease. These effects were consistent across a wide range of subgroups within these populations. This supports the eligibility of a large population with cardiorenal-metabolic diseases for treatment with SGLT2 inhibitors.
520			_aMETHODS: In this systematic review and meta-analysis, we queried online databases (PubMed, Cochrane CENTRAL, and SCOPUS) up to Feb 10, 2024, for primary and secondary analyses of large trials (n>1000) of SGLT2 inhibitors in patients with heart failure, type 2 diabetes, chronic kidney disease, and atherosclerotic cardiovascular disease (including acute myocardial infarction). Outcomes studied included composite of first hospitalisation for heart failure or cardiovascular death, first hospitalisation for heart failure, cardiovascular death, total (first and recurrent) hospitalisation for heart failure, and all-cause mortality. Effect sizes were pooled using random-effects models. This study is registered with PROSPERO, CRD42024513836.
546			_aEnglish
650			_a*Cardiovascular Diseases
650			_a*Diabetes Mellitus, Type 2
650			_a*Heart Failure
650			_a*Sodium-Glucose Transporter 2 Inhibitors
650			_aCardiovascular Diseases/mo [Mortality]
650			_aDiabetes Mellitus, Type 2/co [Complications]
650			_aDiabetes Mellitus, Type 2/dt [Drug Therapy]
650			_aHeart Failure/dt [Drug Therapy]
650			_aHeart Failure/mo [Mortality]
650			_aHospitalization/sn [Statistics & Numerical Data]
650			_aHumans
650			_aRenal Insufficiency, Chronic/co [Complications]
650			_aRenal Insufficiency, Chronic/dt [Drug Therapy]
650			_aRenal Insufficiency, Chronic/mo [Mortality]
650			_aSodium-Glucose Transporter 2 Inhibitors/tu [Therapeutic Use]
650			_zAutomated
651			_aMedStar Union Memorial Hospital
656			_aMedicine
657			_aJournal Article
657			_aMeta-Analysis
657			_aSystematic Review
700			_aHameed, Ishaque _bMUMH
790			_aUsman MS, Bhatt DL, Hameed I, Anker SD, Cheng AYY, Hernandez AF, Jones WS, Khan MS, Petrie MC, Udell JA, Friede T, Butler J
856			_uhttps://dx.doi.org/10.1016/S2213-8587(24)00102-5 _zhttps://dx.doi.org/10.1016/S2213-8587(24)00102-5
942			_cART _dArticle
999			_c14580 _d14580