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Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis
To demonstrate a magnitude of the cardiovascular benefits, concomitantly analyzing the safety outcomes of sodium-glucose cotransporter 2 inhibitor (SGLT2-I) comprehensively, as a class effect in a larger sample size combined from recent randomized control trials. We searched electronic databases usi...
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Published in: | Cardiovascular endocrinology & metabolism 2021-06, Vol.10 (2), p.89-98 |
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container_title | Cardiovascular endocrinology & metabolism |
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creator | Bhattarai, Mukul Salih, Mohsin Regmi, Manjari Al-akchar, Mohammad Koester, Cameron Ibrahim, Abdisamad Parajuli, Priyanka Garcia, Odalys Lara Bhandari, Bishal Rehman, Anis Siddique, Momin |
description | To demonstrate a magnitude of the cardiovascular benefits, concomitantly analyzing the safety outcomes of sodium-glucose cotransporter 2 inhibitor (SGLT2-I) comprehensively, as a class effect in a larger sample size combined from recent randomized control trials.
We searched electronic databases using specific terms and evaluated 6 efficacy and 10 safety outcomes. Odds ratios (ORs) and 95% confidence interval (CI) were used to compare two interventions.
Five studies (
= 41 267) were included, among which 23 539 received SGLT2-I. The SGLT2-I group favored reduction in major adverse cardiovascular events (OR, 0.78; 95% CI, 0.62-0.98;
= 0.03), cardiovascular death (CVD) or heart failure hospitalization (OR, 0.60; 95% CI, 0.46-0.80;
= 0.0004), rate of hospitalization for heart failure (OR, 0.56; 95% CI, 0.44-0.72;
|
doi_str_mv | 10.1097/XCE.0000000000000229 |
format | article |
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We searched electronic databases using specific terms and evaluated 6 efficacy and 10 safety outcomes. Odds ratios (ORs) and 95% confidence interval (CI) were used to compare two interventions.
Five studies (
= 41 267) were included, among which 23 539 received SGLT2-I. The SGLT2-I group favored reduction in major adverse cardiovascular events (OR, 0.78; 95% CI, 0.62-0.98;
= 0.03), cardiovascular death (CVD) or heart failure hospitalization (OR, 0.60; 95% CI, 0.46-0.80;
= 0.0004), rate of hospitalization for heart failure (OR, 0.56; 95% CI, 0.44-0.72;
< 0.00001), CVD (OR, 0.68; 95% CI, 0.50-0.93;
= 0.01), all-cause mortality (OR, 0.67; 95% CI, 0.48-0.93;
= 0.02) and myocardial infarction (OR, 0.79; 95% CI, 0.64-0.99;
= 0.04) when compared to the placebo group. Safety analysis showed higher diabetic ketoacidosis (DKA) rate in SGLT2-I group (OR, 2.33; 95% CI, 1.40-3.90;
= 0.001); in contrast, major hypoglycemic events were significantly lower (OR, 0.79; 95% CI, 0.73-0.87;
< 0.00001). AKI was significantly higher in the placebo group (OR, 0.76; 95% CI, 0.65-0.88;
= 0.0004). There were no statistically significant effects on other outcomes.
In selected high-risk patients of cardiovascular disease, the SGLT2-I is a potential effective class of drugs for improving cardiovascular outcomes and all-cause mortality without an increased risk of all other major complications except DKA on this meta-analysis.</description><identifier>ISSN: 2574-0954</identifier><identifier>EISSN: 2574-0954</identifier><identifier>DOI: 10.1097/XCE.0000000000000229</identifier><identifier>PMID: 34113794</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Original</subject><ispartof>Cardiovascular endocrinology & metabolism, 2021-06, Vol.10 (2), p.89-98</ispartof><rights>Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4534-3f2f0e9dfa06688f7a283e4fedd80850cafdb56a8ac355b950f83849006d123</citedby><cites>FETCH-LOGICAL-c4534-3f2f0e9dfa06688f7a283e4fedd80850cafdb56a8ac355b950f83849006d123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186520/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186520/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34113794$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhattarai, Mukul</creatorcontrib><creatorcontrib>Salih, Mohsin</creatorcontrib><creatorcontrib>Regmi, Manjari</creatorcontrib><creatorcontrib>Al-akchar, Mohammad</creatorcontrib><creatorcontrib>Koester, Cameron</creatorcontrib><creatorcontrib>Ibrahim, Abdisamad</creatorcontrib><creatorcontrib>Parajuli, Priyanka</creatorcontrib><creatorcontrib>Garcia, Odalys Lara</creatorcontrib><creatorcontrib>Bhandari, Bishal</creatorcontrib><creatorcontrib>Rehman, Anis</creatorcontrib><creatorcontrib>Siddique, Momin</creatorcontrib><title>Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis</title><title>Cardiovascular endocrinology & metabolism</title><addtitle>Cardiovasc Endocrinol Metab</addtitle><description>To demonstrate a magnitude of the cardiovascular benefits, concomitantly analyzing the safety outcomes of sodium-glucose cotransporter 2 inhibitor (SGLT2-I) comprehensively, as a class effect in a larger sample size combined from recent randomized control trials.
We searched electronic databases using specific terms and evaluated 6 efficacy and 10 safety outcomes. Odds ratios (ORs) and 95% confidence interval (CI) were used to compare two interventions.
Five studies (
= 41 267) were included, among which 23 539 received SGLT2-I. The SGLT2-I group favored reduction in major adverse cardiovascular events (OR, 0.78; 95% CI, 0.62-0.98;
= 0.03), cardiovascular death (CVD) or heart failure hospitalization (OR, 0.60; 95% CI, 0.46-0.80;
= 0.0004), rate of hospitalization for heart failure (OR, 0.56; 95% CI, 0.44-0.72;
< 0.00001), CVD (OR, 0.68; 95% CI, 0.50-0.93;
= 0.01), all-cause mortality (OR, 0.67; 95% CI, 0.48-0.93;
= 0.02) and myocardial infarction (OR, 0.79; 95% CI, 0.64-0.99;
= 0.04) when compared to the placebo group. Safety analysis showed higher diabetic ketoacidosis (DKA) rate in SGLT2-I group (OR, 2.33; 95% CI, 1.40-3.90;
= 0.001); in contrast, major hypoglycemic events were significantly lower (OR, 0.79; 95% CI, 0.73-0.87;
< 0.00001). AKI was significantly higher in the placebo group (OR, 0.76; 95% CI, 0.65-0.88;
= 0.0004). There were no statistically significant effects on other outcomes.
In selected high-risk patients of cardiovascular disease, the SGLT2-I is a potential effective class of drugs for improving cardiovascular outcomes and all-cause mortality without an increased risk of all other major complications except DKA on this meta-analysis.</description><subject>Original</subject><issn>2574-0954</issn><issn>2574-0954</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNptks9u1DAQxiMEolXpGyDkI5cU27HzhwMSWpWCtBKH9sDNmnXGjWkSL54kq32rPiJeWsqCsCx5pPnm9430OcteC34heFO9-7a6vODHR8rmWXYqdaVy3mj1_Kg-yc6Jvh806SpdvcxOCiVEUTXqNLtfhWEbscOR_IIMF-hnmHwYWXDMQmx9WIDs3ENk6Jy3YPcMxpYROJz2LMyTDQPSQX59tb6RzI-d3_gpREol6_xtx6KnO7ZNWBwn-g-49YRA-J7RniYcktCyiIvH3S-rASfIYYR-T55eZS8c9ITnj-9Zdv3p8mb1OV9_vfqy-rjOrdKFygsnHcemdcDLsq5dBbIuUDls25rXmltw7UaXUIMttN40mru6qFXDedkKWZxlHx6o23kzYGvT4hF6s41-gLg3Abz5uzP6ztyGxdSiLrXkCfD2ERDDjxlpMoMni30PI4aZjNSKa5EcqyRVD1IbA1FE92QjuDmkbVLa5t-009ib4xWfhn5n-4e7C_2Eke76eYfRdAj91Jn0G5QWosoll4KXCZofyKr4Cf43ung</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Bhattarai, Mukul</creator><creator>Salih, Mohsin</creator><creator>Regmi, Manjari</creator><creator>Al-akchar, Mohammad</creator><creator>Koester, Cameron</creator><creator>Ibrahim, Abdisamad</creator><creator>Parajuli, Priyanka</creator><creator>Garcia, Odalys Lara</creator><creator>Bhandari, Bishal</creator><creator>Rehman, Anis</creator><creator>Siddique, Momin</creator><general>Wolters Kluwer Health, Inc. All rights reserved</general><general>Wolters Kluwer Health</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210601</creationdate><title>Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis</title><author>Bhattarai, Mukul ; Salih, Mohsin ; Regmi, Manjari ; Al-akchar, Mohammad ; Koester, Cameron ; Ibrahim, Abdisamad ; Parajuli, Priyanka ; Garcia, Odalys Lara ; Bhandari, Bishal ; Rehman, Anis ; Siddique, Momin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4534-3f2f0e9dfa06688f7a283e4fedd80850cafdb56a8ac355b950f83849006d123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bhattarai, Mukul</creatorcontrib><creatorcontrib>Salih, Mohsin</creatorcontrib><creatorcontrib>Regmi, Manjari</creatorcontrib><creatorcontrib>Al-akchar, Mohammad</creatorcontrib><creatorcontrib>Koester, Cameron</creatorcontrib><creatorcontrib>Ibrahim, Abdisamad</creatorcontrib><creatorcontrib>Parajuli, Priyanka</creatorcontrib><creatorcontrib>Garcia, Odalys Lara</creatorcontrib><creatorcontrib>Bhandari, Bishal</creatorcontrib><creatorcontrib>Rehman, Anis</creatorcontrib><creatorcontrib>Siddique, Momin</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cardiovascular endocrinology & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bhattarai, Mukul</au><au>Salih, Mohsin</au><au>Regmi, Manjari</au><au>Al-akchar, Mohammad</au><au>Koester, Cameron</au><au>Ibrahim, Abdisamad</au><au>Parajuli, Priyanka</au><au>Garcia, Odalys Lara</au><au>Bhandari, Bishal</au><au>Rehman, Anis</au><au>Siddique, Momin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis</atitle><jtitle>Cardiovascular endocrinology & metabolism</jtitle><addtitle>Cardiovasc Endocrinol Metab</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>10</volume><issue>2</issue><spage>89</spage><epage>98</epage><pages>89-98</pages><issn>2574-0954</issn><eissn>2574-0954</eissn><abstract>To demonstrate a magnitude of the cardiovascular benefits, concomitantly analyzing the safety outcomes of sodium-glucose cotransporter 2 inhibitor (SGLT2-I) comprehensively, as a class effect in a larger sample size combined from recent randomized control trials.
We searched electronic databases using specific terms and evaluated 6 efficacy and 10 safety outcomes. Odds ratios (ORs) and 95% confidence interval (CI) were used to compare two interventions.
Five studies (
= 41 267) were included, among which 23 539 received SGLT2-I. The SGLT2-I group favored reduction in major adverse cardiovascular events (OR, 0.78; 95% CI, 0.62-0.98;
= 0.03), cardiovascular death (CVD) or heart failure hospitalization (OR, 0.60; 95% CI, 0.46-0.80;
= 0.0004), rate of hospitalization for heart failure (OR, 0.56; 95% CI, 0.44-0.72;
< 0.00001), CVD (OR, 0.68; 95% CI, 0.50-0.93;
= 0.01), all-cause mortality (OR, 0.67; 95% CI, 0.48-0.93;
= 0.02) and myocardial infarction (OR, 0.79; 95% CI, 0.64-0.99;
= 0.04) when compared to the placebo group. Safety analysis showed higher diabetic ketoacidosis (DKA) rate in SGLT2-I group (OR, 2.33; 95% CI, 1.40-3.90;
= 0.001); in contrast, major hypoglycemic events were significantly lower (OR, 0.79; 95% CI, 0.73-0.87;
< 0.00001). AKI was significantly higher in the placebo group (OR, 0.76; 95% CI, 0.65-0.88;
= 0.0004). There were no statistically significant effects on other outcomes.
In selected high-risk patients of cardiovascular disease, the SGLT2-I is a potential effective class of drugs for improving cardiovascular outcomes and all-cause mortality without an increased risk of all other major complications except DKA on this meta-analysis.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>34113794</pmid><doi>10.1097/XCE.0000000000000229</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Original |
title | Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis |
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