Heart failure & cardiomyopathies

Effect of sodium-glucose cotransporter-2 inhibitors on haemoglobin and haematocrit levels in heart failure: a systematic review and meta-analysis

ESC Heart FailPublished systematic review and meta-analysis

Pooled result · HbResult — go to the resultMD 0.68 g/dl 95% CI 0.53–0.83

Authors' conclusion

Sodium-glucose cotransporter-2 inhibitors significantly increase levels of Hb and Hct in patients with HF. Further research is warranted to assess clinical significance in relation to Hb and Hct changes in patients with pre-existing anaemia or renal dysfunction.

Study context

Population
Patients with heart failure (HF) treated with SGLT2 inhibitors compared to control subjects, in randomized controlled trialsSeventeen randomized controlled trials (RCTs), mean age 68.65 years, 65.56% male
Participants
16,784 patients
Comparison
HF patients treated with SGLT2 inhibitors compared to control subjects
Outcome
Haemoglobin (Hb)
Methodological detailsrandom-effects model
  • Random-effects model

Pooled result

As reported in the abstract

MD

0.68 g/dl

95% CI 0.53–0.83

P < 0.0001

SGLT2 inhibitorsvs controls
MD 0.68 g/dl (95% CI 0.53–0.83); P < 0.0001

Further pooled results

OutcomeMD (%) (95% CI)P value
HctI2 = 66.6%; increased with SGLT2 inhibitors2.15 (1.73–2.57)P < 0.0001

Subgroup analyses

Consistent benefits across individual SGLT2 inhibitors, duration of follow-up (≥6 months vs <6 months), and comparator type (placebo vs active control)

Publication bias

No evidence of publication bias

Original publication

Effect of sodium-glucose cotransporter-2 inhibitors on haemoglobin and haematocrit levels in heart failure: a systematic review and meta-analysis. ESC Heart Fail. Published 19 January 2026. doi:10.1093/eschf/xvag027

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