A new meta-analysis shows that sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective in patients with either diabetes, heart failure, or chronic kidney disease (CKD) who are at increased risk of atherosclerotic cardiovascular disease (ASCVD). Shown to reduce the risk of serious adverse cardiovascular events. The findings were presented at the American College of Cardiology Annual Scientific Session & Expo and published concurrently. Circulation.

SGLT2 inhibitors, also known as gliflozin, are a type of drug that lowers blood sugar levels by increasing their excretion in the urine. Late-stage trials of these drugs have demonstrated reductions in heart failure and adverse renal outcomes, but the impact on major adverse cardiovascular events (MACE) such as cardiovascular death, myocardial infarction, and stroke is less clear. It wasn’t.

Researchers analyzed data from 11 trials involving 78,607 people with diabetes, heart failure, or CKD and found that combining an SGLT2 inhibitor with a placebo resulted in a 9% reduction in MACE and a 9% reduction in cardiovascular death. was found to have decreased by 14%.

This analysis showed a surprisingly consistent effect across all three patient groups as well as major subgroups (history of ASCVD, history of myocardial infarction, diabetes, history of heart failure, and varying levels of renal function). was shown. The decrease in MACE was driven by a decrease in cardiovascular deaths, particularly heart failure deaths and sudden cardiac deaths. There was no significant effect on myocardial infarction or stroke.

Dr. Brendon Nguyen, a senior research fellow at the George Institute for Global Health and an author of the paper, said: “In trials of individual SGLT2 inhibitors, we observed some efficacy in reducing cardiovascular disease, but the major “The effects on different types of cardiovascular events across patient subgroups were uncertain.”

“By comprehensively reviewing global data from all large, placebo-controlled outcome trials on SGLT2 inhibitors, we observed a definitive reduction in cardiovascular death in patients with a wide range of clinical characteristics. I did.”

Diabetes is a known risk factor for cardiovascular and kidney disease, where impaired blood sugar control causes damage to blood vessels in the heart and kidneys. Many people with diabetes have ASCVD, CKD, or heart failure, and the prevalence increases as years pass after diagnosis.

Dr. Neuen added, “Despite the various benefits of SGLT2 inhibitors for cardiovascular, renal, and metabolic diseases, this class of drugs remains underprescribed.”

“We hope that our findings will help in the more appropriate prescribing of SGLT2 inhibitors, especially in patients with diabetes and heart failure or chronic kidney disease, who may experience multiple therapeutic effects.”