Cardiometabolic & kidney

Sodium-Glucose Cotransporter-2 Inhibitors and Major Adverse Cardiovascular Outcomes: A SMART-C Collaborative Meta-Analysis

CirculationPublished Systematic review and meta-analysis of randomised trials

Pooled result · MACEResult — go to the resultHazard ratio 0.91 95% CI 0.87–0.96

Authors' conclusion

SGLT2i reduce the risk of MACE across a broad range of patients irrespective of atherosclerotic cardiovascular disease, diabetes, kidney function, or other major clinical characteristics at baseline.

Study context

Population
Patients with DM at high risk for atherosclerotic CVD, HF, or CKD in phase 3 placebo-controlled outcomes trials of SGLT2i
Participants
78,607 patients11 trials
Comparison
SGLT2i vs placebo
Outcome
Major adverse cardiovascular events (MACE):
  • CV death
  • MI
  • Stroke
Methodological detailscollaborative trial-level meta-analysis, placebo-controlled trials
  • Collaborative trial-level meta-analysis
  • Placebo-controlled trials

Pooled result

MACE

Hazard ratio

0.91

95% CI 0.87–0.96

P < 0.0001

SGLT2ivs Placebo
HR 0.91 (95% CI 0.87–0.96); P < 0.0001

As reported in the abstract

Further pooled results

OutcomeHR (95% CI)P value
CV death0.86 (0.81–0.92)P < 0.0001
MI (overall population)No significant effect0.95 (0.87–1.04)P = 0.29
StrokeNo effect0.99 (0.91–1.07)P = 0.77

HF death

HF death HR (driver of CV death benefit)
HR, 0.68 [95% CI, 0.46-1.02]

Sudden cardiac death

Sudden cardiac death HR (driver of CV death benefit)
HR, 0.86 [95% CI, 0.78-0.95]

CV death benefit by albuminuria (subgroup)

Generally consistent across subgroups; possibly more apparent with albuminuria
P for interaction = 0.02

Original publication

Sodium-Glucose Cotransporter-2 Inhibitors and Major Adverse Cardiovascular Outcomes: A SMART-C Collaborative Meta-Analysis. Circulation. Published 7 April 2024. doi:10.1161/circulationaha.124.069568

Composed by AI from the published abstract and checked against it. How Briefs are made →

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