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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Cardiovascular outcomes with sodium–glucose cotransporter-2 inhibitors in patients with type II diabetes mellitus: A meta-analysis of placebo-controlled randomized trials
International Journal of Cardiology, Volume 228, Year 2017
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Description
Background The impact of sodium–glucose cotransporter-2 (SGLT-2) inhibitors on cardiovascular outcomes in patients with type II diabetes mellitus (DM) is not well established. Methods We searched electronic databases from inception through July 2016 for randomized, placebo-controlled trials, involving SGLT-2 inhibitors. Fixed-effects summary odds ratios (OR) were constructed using Peto model. Results Eighty-one trials with a total of 37,195 patients were included. The mean follow-up was 89 weeks. Compared with placebo, SGLT-2 inhibitors were associated with a lower risk of all-cause mortality (OR 0.72; 95% CI 0.59–0.86; P < 0.001), cardiovascular mortality (OR 0.67; 95% CI 0.53–0.84; P = 0.001), and heart failure (OR 0.67; 95% CI 0.51–0.87; P = 0.003), but a similar risk of myocardial infarction (OR 0.89; 95% CI 0.74–1.09; P = 0.29) and stroke/transient ischemic attack (OR 1.09; 95% CI 0.87–1.37; P = 0.47). The reduction in all-cause mortality was noticed with empagliflozin (OR 0.66; 95% CI 0.54–0.81; P < 0.001), but not with other SGLT-2 inhibitors (ORdapagliflozin 1.37; 95% CI 0.71–2.62; P = 0.35; ORcanagliflozin 0.82; 95% CI 0.41–1.68; P = 0.59; ORluseogliflozin 4.6; 95% CI 0.07–284.25; P = 0.47; and ORipragliflozin 4.73; 95% CI 0.08–283.14; P = 0.46) (Pinteraction = 0.19). Potential harm was observed with dapagliflozin on cardiovascular mortality (OR 2.15, 95% CI 0.92–5.04, P = 0.08). Conclusions In patients with type II DM, SGLT-2 inhibitors appeared to reduce both all-cause and cardiovascular mortality, primarily due to reduction in the risk of heart failure. The benefit was only seen with empagliflozin. There was suggestion of potential harm with dapagliflozin, thus future trials are needed to ascertain the cardiovascular safety of other agents in this class. © 2016 Elsevier Ireland Ltd
Authors & Co-Authors
Saad, Marwan
United States, Little Rock
University of Arkansas for Medical Sciences
Mahmoud, Ahmed N.
United States, Gainesville
University of Florida
Elgendy, Islam Y.
United States, Gainesville
University of Florida
Abuzaid, Ahmed Sami
United States, Wilmington
Christiana Care Health System
Barakat, Amr F.
United States, Cleveland
Cleveland Clinic Foundation
Elgendy, Akram Y.
United States, Gainesville
University of Florida
Al-Ani, Mohammad A.Z.
United States, Gainesville
University of Florida
Mentias, Amgad
United States, Iowa City
University of Iowa Carver College of Medicine
Nairooz, Ramez S.
United States, Little Rock
University of Arkansas for Medical Sciences
Mukherjee, Debabrata P.
United States, El Paso
Texas Tech University Health Sciences Center el Paso
Statistics
Citations: 56
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1016/j.ijcard.2016.11.181
ISSN:
01675273
Research Areas
Noncommunicable Diseases
Study Design
Cohort Study
Study Approach
Systematic review