SGLT2 inhibitors may be associated with a reduced risk of major adverse cardiovascular events (MACE) and heterogeneity of cardiovascular death in patients with type 2 diabetes, according to a study published Oct. 7 in JAMA: Cardiology.

Darren K. McGuire, MD, MHSc, FACC, et al., sought to assess the cardiovascular and kidney outcomes of all four available SGLT2 inhibitors in patients with type 2 diabetes by performing a meta-analysis of six outcomes trials.

The primary outcome was the time to first MACE. Secondary outcomes included the composite of hospitalization for heart failure (HF) or cardiovascular death and each component, all-cause mortality and a composite of kidney outcomes. Of the 46,969 patients included in the study, 66.2% had atherosclerotic cardiovascular disease (ASCVD). The mean age of patients was 63.7, 65.9% of patients were male and 78.5% of patients were white.

Results showed that SGLT2 inhibitors were associated with reduced risk of MACE, hospitalization for HF, cardiovascular death and kidney outcomes, "with no significant heterogeneity of associations with outcome." Researchers also found that associated risk reduction for hospitalization for HF was consistent across the trials and significant heterogeneity of associations with outcomes was observed for cardiovascular death. Further, they found that the presence or absence of ASCVD had no effect on the association with outcomes for MACE, hospitalization for HF, cardiovascular death or kidney outcomes.

"Across the class, there are robust and consistent associations with reduction in risk for HF [hospitalization], independent of baselines ASCVD status or kidney function," write McGuire et al. "These data support contemporary society recommendations to prioritize the use of SGLT2 inhibitors with demonstrated outcomes, independent of glucose control considerations, in patients with [type 2 diabetes] with or at high risk for [cardiovascular] and kidney complications."

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Diabetes Mellitus, Type 2, Blood Glucose, Cardiovascular Diseases, Atherosclerosis, Heart Failure, Cardiovascular System, Hospitalization, Cardiology, Risk Reduction Behavior

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