Literature DB >> 34113794

Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis.

Mukul Bhattarai1, Mohsin Salih1, Manjari Regmi2, Mohammad Al-Akchar1, Cameron Koester2, Abdisamad Ibrahim2, Priyanka Parajuli2, Odalys Lara Garcia2, Bishal Bhandari2, Anis Rehman3, Momin Siddique1.   

Abstract

OBJECTIVES: To demonstrate a magnitude of the cardiovascular benefits, concomitantly analyzing the safety outcomes of sodium-glucose cotransporter 2 inhibitor (SGLT2-I) comprehensively, as a class effect in a larger sample size combined from recent randomized control trials.
METHODS: We searched electronic databases using specific terms and evaluated 6 efficacy and 10 safety outcomes. Odds ratios (ORs) and 95% confidence interval (CI) were used to compare two interventions.
RESULTS: Five studies (n = 41 267) were included, among which 23 539 received SGLT2-I. The SGLT2-I group favored reduction in major adverse cardiovascular events (OR, 0.78; 95% CI, 0.62-0.98; P = 0.03), cardiovascular death (CVD) or heart failure hospitalization (OR, 0.60; 95% CI, 0.46-0.80; P = 0.0004), rate of hospitalization for heart failure (OR, 0.56; 95% CI, 0.44-0.72; P < 0.00001), CVD (OR, 0.68; 95% CI, 0.50-0.93; P = 0.01), all-cause mortality (OR, 0.67; 95% CI, 0.48-0.93; P = 0.02) and myocardial infarction (OR, 0.79; 95% CI, 0.64-0.99; P = 0.04) when compared to the placebo group. Safety analysis showed higher diabetic ketoacidosis (DKA) rate in SGLT2-I group (OR, 2.33; 95% CI, 1.40-3.90; P = 0.001); in contrast, major hypoglycemic events were significantly lower (OR, 0.79; 95% CI, 0.73-0.87; P < 0.00001). AKI was significantly higher in the placebo group (OR, 0.76; 95% CI, 0.65-0.88; P = 0.0004). There were no statistically significant effects on other outcomes.
CONCLUSION: In selected high-risk patients of cardiovascular disease, the SGLT2-I is a potential effective class of drugs for improving cardiovascular outcomes and all-cause mortality without an increased risk of all other major complications except DKA on this meta-analysis.
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Entities:  

Keywords:  cardiovascular disease; inhibitor; meta-analysis; randomized controlled trial

Year:  2020        PMID: 34113794      PMCID: PMC8186520          DOI: 10.1097/XCE.0000000000000229

Source DB:  PubMed          Journal:  Cardiovasc Endocrinol Metab        ISSN: 2574-0954


  22 in total

1.  Empagliflozin and Assessment of Lower-Limb Amputations in the EMPA-REG OUTCOME Trial.

Authors:  Silvio E Inzucchi; Hristo Iliev; Egon Pfarr; Bernard Zinman
Journal:  Diabetes Care       Date:  2017-11-13       Impact factor: 19.112

2.  SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials.

Authors:  Thomas A Zelniker; Stephen D Wiviott; Itamar Raz; Kyungah Im; Erica L Goodrich; Marc P Bonaca; Ofri Mosenzon; Eri T Kato; Avivit Cahn; Remo H M Furtado; Deepak L Bhatt; Lawrence A Leiter; Darren K McGuire; John P H Wilding; Marc S Sabatine
Journal:  Lancet       Date:  2018-11-10       Impact factor: 79.321

3.  Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes.

Authors:  Stephen D Wiviott; Itamar Raz; Marc P Bonaca; Ofri Mosenzon; Eri T Kato; Avivit Cahn; Michael G Silverman; Thomas A Zelniker; Julia F Kuder; Sabina A Murphy; Deepak L Bhatt; Lawrence A Leiter; Darren K McGuire; John P H Wilding; Christian T Ruff; Ingrid A M Gause-Nilsson; Martin Fredriksson; Peter A Johansson; Anna-Maria Langkilde; Marc S Sabatine
Journal:  N Engl J Med       Date:  2018-11-10       Impact factor: 91.245

Review 4.  Activation and Inhibition of Sodium-Hydrogen Exchanger Is a Mechanism That Links the Pathophysiology and Treatment of Diabetes Mellitus With That of Heart Failure.

Authors:  Milton Packer
Journal:  Circulation       Date:  2017-10-17       Impact factor: 29.690

5.  A safety update on sodium glucose co-transporter 2 inhibitors.

Authors:  David Fitchett
Journal:  Diabetes Obes Metab       Date:  2019-04       Impact factor: 6.577

6.  Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes.

Authors:  Bruce Neal; Vlado Perkovic; Kenneth W Mahaffey; Dick de Zeeuw; Greg Fulcher; Ngozi Erondu; Wayne Shaw; Gordon Law; Mehul Desai; David R Matthews
Journal:  N Engl J Med       Date:  2017-06-12       Impact factor: 91.245

Review 7.  Sodium-Glucose Co-Transporter 2 Inhibitors and Fracture Risk.

Authors:  Anastasia Erythropoulou-Kaltsidou; Georgios Polychronopoulos; Konstantinos Tziomalos
Journal:  Diabetes Ther       Date:  2019-11-16       Impact factor: 2.945

Review 8.  SGLT-2 Inhibitors in Heart Failure: Current Management, Unmet Needs, and Therapeutic Prospects.

Authors:  Carolyn S P Lam; Chanchal Chandramouli; Vineeta Ahooja; Subodh Verma
Journal:  J Am Heart Assoc       Date:  2019-10-12       Impact factor: 5.501

9.  Risk of lower extremity amputations in people with type 2 diabetes mellitus treated with sodium-glucose co-transporter-2 inhibitors in the USA: A retrospective cohort study.

Authors:  Zhong Yuan; Frank J DeFalco; Patrick B Ryan; Martijn J Schuemie; Paul E Stang; Jesse A Berlin; Mehul Desai; Norm Rosenthal
Journal:  Diabetes Obes Metab       Date:  2017-10-11       Impact factor: 6.577

Review 10.  SGLT2 Inhibitors Play a Salutary Role in Heart Failure via Modulation of the Mitochondrial Function.

Authors:  Yasuhiro Maejima
Journal:  Front Cardiovasc Med       Date:  2020-01-08
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  2 in total

1.  Effects of treatment with SGLT-2 inhibitors on arginine-related cardiovascular and renal biomarkers.

Authors:  Arne Gessner; Anna Gemeinhardt; Agnes Bosch; Dennis Kannenkeril; Christian Staerk; Andreas Mayr; Martin F Fromm; Roland E Schmieder; Renke Maas
Journal:  Cardiovasc Diabetol       Date:  2022-01-06       Impact factor: 9.951

2.  Association of Sodium-Glucose Cotransporter 2 Inhibitors With Cardiovascular Outcomes in Patients With Type 2 Diabetes and Other Risk Factors for Cardiovascular Disease: A Meta-analysis.

Authors:  Mukul Bhattarai; Mohsin Salih; Manjari Regmi; Mohammad Al-Akchar; Radhika Deshpande; Zurain Niaz; Abhishek Kulkarni; Momin Siddique; Shruti Hegde
Journal:  JAMA Netw Open       Date:  2022-01-04
  2 in total

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