Cardiometabolic & kidneyMeta-analysis
Sodium–glucose cotransporter 2 inhibitors across cardio-reno-metabolic disease and body mass index: a meta-analysis of randomized controlled trials
- meta-analysis of randomized controlled trials
- random-effects
- Body mass index (BMI) cutoff of 30 kg/m²
Authors' conclusion
Across a broad CRM population, SGLT2i reduce cardiovascular death or HF hospitalization and all-cause death irrespective of BMI.
Study context
- Population
- Patients with heart failure (HF), chronic kidney disease (CKD), and/or T2D in randomized controlled trials (RCTs) comparing SGLT2i with placebo that reported BMI-stratified outcomesEight RCTs, mean BMI 29.95 kg/m²
- Participants
- 57,356 patients
- Comparison
- SGLT2i with placebo, stratified by BMI <30 kg/m² and ≥30 kg/m²
Pooled result
As reported in the abstract
Cardiovascular death or HF hospitalization, BMI <30 kg/m²
Relative risk
0.80
95% CI 0.72–0.89
SGLT2i vs placebo
RR 0.80 (95% CI 0.72–0.89)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Cardiovascular death or HF hospitalization, BMI ≥30 kg/m² | 0.80 (0.75–0.85) | |
| 0.512Relative risk (log scale) |
| Outcome | RR |
|---|---|
| HF hospitalization — SGLT2i vs placebo · BMI <30 kg/m² | 0.75 |
| HF hospitalization — SGLT2i vs placebo · BMI ≥30 kg/m² | 0.74 |
| All-cause mortality — SGLT2i vs placebo · BMI <30 kg/m² | 0.83 |
| All-cause mortality — SGLT2i vs placebo · BMI ≥30 kg/m² | 0.89 |
Cardiovascular death or HF hospitalization, BMI ≥30 kg/m²
- no evidence of effect modification by BMI, an effect primarily driven by reductions in heart failure hospitalizations
Meta-regression and sensitivity analyses
- Meta-regression identified disease category and SGLT2i molecule as sources of heterogeneity, without altering the absence of BMI interaction
- Sensitivity, cumulative, and bootstrap analyses confirmed the robustness of the results
Original publication
Sodium–glucose cotransporter 2 inhibitors across cardio-reno-metabolic disease and body mass index: a meta-analysis of randomized controlled trials. Eur Heart J Qual Care Clin Outcomes. Published 6 April 2026. doi:10.1093/ehjqcco/qcag061
Summarised from the published abstract; every number is checked against it