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posted on 07.03.2022, 05:07 authored by 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
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.

History

References