Blog
About

10
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Cardiovascular Safety, Long‐Term Noncardiovascular Safety, and Efficacy of Sodium–Glucose Cotransporter 2 Inhibitors in Patients With Type 2 Diabetes Mellitus: A Systemic Review and Meta‐Analysis With Trial Sequential Analysis

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The cardiovascular and long‐term noncardiovascular safety and efficacy of SGLT2 (sodium–glucose cotransporter 2) inhibitors have not been well documented.

          Methods and Results

          For cardiovascular outcomes, we performed a meta‐analysis with trial sequential analysis of randomized controlled trials and adjusted observational studies, each with a minimum of 26 weeks and 2000 patient‐years of follow‐up. For long‐term noncardiovascular safety and efficacy outcome analyses, we included only randomized controlled trials with at least 2 years and 1000 patient‐years of follow‐up. Five studies with 351 476 patients were included in cardiovascular outcomes analysis. Meta‐analyses showed that SGLT2 inhibitors significantly reduced the risks of major adverse cardiac events (hazard ratio [ HR]: 0.80; 95% confidence interval [ CI], 0.69–0.92; P=0.002), all‐cause mortality ( HR: 0.67; 95% CI, 0.54–0.84; P<0.001), cardiovascular mortality ( HR: 0.77; 95% CI, 0.60–0.98; P=0.03), nonfatal myocardial infarction ( HR: 0.86; 95% CI, 0.76–0.98; P=0.02), hospitalization for heart failure ( HR: 0.62; 95% CI, 0.55–0.69; P<0.001), and progression of albuminuria ( HR: 0.68; 95% CI, 0.58–0.81; P<0.001). No significant difference in nonfatal stroke was found. Analyses limited to randomized controlled trials showed similar findings. Trial sequential analysis provided firm evidence of a 20% reduction in major adverse cardiac events, all‐cause mortality, and hospitalization for heart failure with SGLT2 inhibitors, but evidence remains inconclusive for cardiovascular mortality. Nine randomized controlled trials contributed to long‐term noncardiovascular and efficacy analyses. SGLT2 inhibitors reduced incidence of hypoglycemia and acute kidney injury but increased the risks of urinary tract and genital infections.

          Conclusions

          SGLT2 inhibitors showed remarkable cardiovascular‐ and renal‐protective effects and good long‐term noncardiovascular safety with sustained efficacy.

          Related collections

          Most cited references 56

          • Record: found
          • Abstract: not found
          • Article: not found

          Measuring inconsistency in meta-analyses.

            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes.

              The effects of empagliflozin, an inhibitor of sodium-glucose cotransporter 2, in addition to standard care, on cardiovascular morbidity and mortality in patients with type 2 diabetes at high cardiovascular risk are not known.
                Bookmark

                Author and article information

                Contributors
                huang_ja@163.com
                xubiao@medmail.com.cn
                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                20 January 2018
                January 2018
                : 7
                : 2 ( doiID: 10.1002/jah3.2018.7.issue-2 )
                Affiliations
                [ 1 ] Department of Cardiology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing China
                [ 2 ] Department of Respiratory Medicine The First Affiliated Hospital of Soochow University Suzhou China
                Author notes
                [* ] Correspondence to: Biao Xu, MD, PhD, and Jian‐An Huang, MD, Department of Cardiology, Affiliated Drum Tower Hospital, Nanjing University School of Medicine, 321 Zhongshan Road, Nanjing, Jiangsu Province 210008, China. E‐mails: xubiao@ 123456medmail.com.cn , huang_ja@ 123456163.com
                [†]

                Dr Zhang and Dr Zhu are co‐first authors.

                Article
                JAH32878
                10.1161/JAHA.117.007165
                5850151
                29353233
                © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                Page count
                Figures: 8, Tables: 3, Pages: 43, Words: 9934
                Product
                Funding
                Funded by: National Natural Science Foundation of China
                Award ID: 81600312
                Award ID: 81600285
                Funded by: Fundamental Research Funds for the Central Universities
                Award ID: 021414380248
                Categories
                Systematic Review and Meta‐Analysis
                Systematic Review and Meta‐Analysis
                Custom metadata
                2.0
                jah32878
                January 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.1 mode:remove_FC converted:23.01.2018

                Comments

                Comment on this article