Sodium Glucose Cotransporter Type 2 Inhibitors Improve Cardiorenal Outcome of Patients With Coronary Artery Disease: A Meta-Analysis.

Abstract

Objective:

Sodium glucose cotransporter type 2 inhibitors (SGLT-2i) are beneficial for cardiorenal outcomes in patients with type 2 diabetes mellitus (T2DM), heart failure (HF) or chronic kidney disease (CKD). However, whether or not the patients with coronary artery disease (CAD) have prognostic benefit from SGLT-2i treatment has not been fully studied. The purpose of this meta-analysis is to determine the prognostic benefit of SGLT-2i administration in CAD patients.

Methods:

We searched the PubMed, Embase and Cochrane Library from inception until October 15, 2021. We included randomized controlled trials (RCTs) reporting the effect of SGLT-2i on major adverse cardiovascular event (MACE), hospitalization for heart failure (HHF), cardiovascular (CV) death and cardiorenal parameters in CAD patients. Hazard ratio (HR) with 95% confidence interval (CI) and mean difference (MD) from trials were meta-analyzed using fixed-effects models.

Results:

Nine trials enrolling 15,301 patients with CAD were included in the analyses. Overall, SGLT2i were associated with a reduced risk of MACE (HR: 0.84; 95% CI 0.74-0.95; I2 = 0%), HHF (HR: 0.69; 95% CI 0.58-0.83; I2 = 0%) and a composite of CV death or HHF (HR: 0.78; 95% CI 0.71-0.86; I2 = 37%) in CAD patients. Compared with control group, estimated glomerular filtration rate (eGFR) level decreased less in SGLT-2i group (mean difference [MD] = -3.60, 95% CI, -5.90 to -1.30, p = 0.002; I2 = 0%).

Conclusions:

SGLT-2i can improve cardiorenal outcomes in CAD patients. Further RCTs and real world studies are need to investigate the effect of SGLT2i on CAD patients.

Systematic Review Registration:

PROSPERO, CRD42021258237.

• Authors: Wen Wei, Jin Liu, Shiqun Chen, Xinghao Xu, Dachuan Guo, Yibo He, Zhidong Huang, Bo Wang, Haozhang Huang, Qiang Li, Jiyan Chen, Hong Chen, Ning Tan, Yong Liu
• Journal: Frontiers in endocrinology (Front Endocrinol (Lausanne)) Vol. 13 Pg. 850836 ( 2022) ISSN: 1664-2392 [Print] Switzerland
• PMID: 35330914 (Publication Type: Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review)
• Copyright: Copyright © 2022 Wei, Liu, Chen, Xu, Guo, He, Huang, Wang, Huang, Li, Chen, Chen, Tan and Liu.

Chemical References

• Sodium-Glucose Transport Proteins
• Sodium-Glucose Transporter 2 Inhibitors

Topics

• Coronary Artery Disease (complications, drug therapy)
• Diabetes Mellitus, Type 2 (complications, drug therapy)
• Heart Failure (complications)
• Humans
• Sodium-Glucose Transport Proteins
• Sodium-Glucose Transporter 2 Inhibitors (pharmacology, therapeutic use)