| Title: |
Sodium-glucose cotransporter-2 inhibitors and major adverse cardiovascular outcomes: a SMART-C collaborative meta-analysis |
| Authors: |
Patel, SM; Kang, YM; Im, K; Neuen, BL; Anker, SD; Bhatt, DL; Butler, J; Cherney, DZI; Claggett, BL; Fletcher, RA; Herrington, WG; Inzucchi, SE; Jardine, MJ; Mahaffey, KW; McGuire, DK; McMurray, JJV; Neal, B; Packer, M; Perkovic, V; Solomon, SD; Staplin, N; Vaduganathan, M; Wanner, C; Wheeler, DC; Zannad, F; Zhao, Y; Heerspink, HJL; Sabatine, MS; Wiviott, SD |
| Publisher Information: |
American Heart Association |
| Publication Year: |
2025 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
BACKGROUND: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) consistently improve heart failure and kidney-related outcomes; however, effects on major adverse cardiovascular events (MACE) across different patient populations are less clear. METHODS: This was a collaborative trial-level meta-analysis from the SGLT2i Meta-analysis Cardio-Renal Trialists Consortium, which includes all phase 3, placebo-controlled, outcomes trials of SGLT2i across 3 patient populations (patients with diabetes at high risk for atherosclerotic cardiovascular disease, heart failure [HF], or chronic kidney disease). The outcomes of interest were MACE (composite of cardiovascular death, myocardial infarction, or stroke), individual components of MACE (inclusive of fatal and nonfatal events), all-cause mortality, and death subtypes. Effect estimates for SGLT2i versus placebo were meta-analyzed across trials and examined across key subgroups (established atherosclerotic cardiovascular disease, previous myocardial infarction, diabetes, previous HF, albuminuria, chronic kidney disease stages, and risk groups). RESULTS: A total of 78 607 patients across 11 trials were included: 42 568 (54.2%), 20 725 (26.4%), and 15 314 (19.5%) were included from trials of patients with diabetes at high risk for atherosclerotic cardiovascular disease, HF, or chronic kidney disease, respectively. SGLT2i reduced the rate of MACE by 9% (hazard ration [HR], 0.91 [95% CI, 0.87–0.96], P |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://doi.org/10.1161/circulationaha.124.069568 |
| DOI: |
10.1161/circulationaha.124.069568 |
| Availability: |
https://doi.org/10.1161/circulationaha.124.069568; https://ora.ox.ac.uk/objects/uuid:341ed597-5318-4cf6-868b-e57b4f1ed5c6 |
| Rights: |
info:eu-repo/semantics/openAccess ; CC Attribution-NonCommercial-NoDerivatives (CC BY-NC-ND) |
| Accession Number: |
edsbas.3B3F6978 |
| Database: |
BASE |