Systematic review of the effects of sodium-glucose cotransporter 2 inhibitors on hospitalization for heart failure and cardiac structure or function, and exploratory assessment of potential mechanisms

Abstract

In the past 5 years, there has been a profound shift in the therapeutic focus of trials of sodium-glucose cotransporter 2 inhibitors (SGLT2is). Although initially explored and introduced as glucose-lowering agents for patients with type 2 diabetes mellitus (T2DM), 1 clinical investigation of these molecules has evolved towards heart failure (HF) and chronic kidney disease (CKD) outcomes in patients with and without T2DM. We systematically reviewed randomized controlled trial (RCT) data assessing the effects of SGLT2 is compared with placebo on hospitalization for HF (HHF), cardiac structure and cardiac function, in a PRISMA-compliant manner. We also reviewed, in an exploratory manner, mechanistic evidence for how SGLT2 is may exert their benefits