Affiliation:
1. Department of Pharmacy Peking University Third Hospital Beijing China
2. Department of Pharmaceutical Management and Clinical Pharmacy College of Pharmacy, Peking University Beijing China
3. Department of Cardiology and Institute of Vascular Medicine Peking University Third Hospital; State Key Laboratory of Vascular Homeostasis and Remodelling, Peking University; NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Peking University; Beijing Key Laboratory of Cardiovascular Receptors Research Beijing China
Abstract
AbstractAimTo assess whether sodium‐glucose cotransporter‐2 (SGLT2) inhibitors reduce myocardial infarction (MI) incidence in patients with or without type 2 diabetes.MethodsPubMed, Embase, Web of Science, the Cochrane library, and https://ClinicalTrials.gov were searched up to 7 May 2022. Randomized controlled trials (RCTs) and cohort studies reporting the effects of SGLT2 inhibitor treatment on MI incidence were included. Relative risks (RRs) with a 95% confidence interval (CI) for MI incidence were extracted and pooled. Subgroup analysis and meta‐regression were performed to explore the heterogeneity.ResultsThis meta‐analysis included 54 RCTs and 32 cohort studies, with data from six SGLT2 inhibitors and 3 394 423 individuals. In the overall analysis, SGLT2 inhibitors significantly reduced MI incidence in RCTs (RR 0.9, 95% CI 0.84–0.96) and cohort studies (RR 0.89, 95% CI 0.83–0.94). In RCTs, the results of the subgroup analysis revealed no significant alterations in outcomes based on different SGLT2 inhibitor types, control drug types, cardiovascular disease (CVD) status and sources of outcome extraction (p for interaction >0.05). In cohort studies, the presence or absence of CVD led to similar effects of SGLT2 inhibitors on decreasing MI incidence (p for interaction = 0.179). However, variations in results were observed based on the type of control group in cohort studies (p for interaction = 0.036). Meta‐regression results did not reveal an association between baseline cardiovascular risk factors, follow‐up length, or MI incidence.ConclusionsIn both RCTs and cohort studies, SGLT2 inhibitors reduced MI incidence. The cardioprotective effects of SGLT2 inhibitors were observed in patients with and without a history of CVD.
Funder
Beijing Municipal Natural Science Foundation
National Key Research and Development Program of China
National Natural Science Foundation of China
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism,Internal Medicine