Effects Of SGLT2 Inhibitors On Hospitalization For Heart Failure In Type 2 Diabetes:a Meta-analysis Of Randomized Controlled And Observational Studies

0bjective:To assess the effects of SGLT2 inhibitors on the risk of h HF(hospitalization for heart failure)in patients with type 2 diabetes mellitus.Methods: This study systematically searched the database of Embase,Pub Med,Cochrane Libray,and Clinical Trials.gov up to December 2020 using Me SH and specific keywords.This study retrieved all those studies that explicitly looked for h HF as a prespecified end point,using the method of Preferred Reporting Item for Systematic Reviews and Meta-Analysis(PRISMA)Statement.Then,all the meta-analysis was performed using Stata 15.0 software.Results: A total of 4 RCTs and 6 observational studies were included.(RCTs,n =38723;observational studies,n =1029223).The meta-analytic hazard ratio estimate for h HF with SGLT2 i vs non-SGLT2 i was 0.68(95%CI 0.60～0.76,p=0.720)in RCTs,0.68(95%CI0.60～0.76,p=0.720)in observational studies,No consistent differences were observed between and other SGLT2 i.The outcome of empagliflozin,canagliflozin,and dapagliflozin are consistent.Compared with the control group,the three drugs reduced the hospitalization risk of heart failure by empagliflozin 35%(HR=0.65,95%CI 0.50～0.85,p=0.000),canagliflozin 38%(HR=0.62,95%CI0.55～0.70,p=0.558),dapagliflozin32%(HR=0.68,95% CI 0.59～0.78,p=0.258)respectively.Conclusions: In this large comprehensive analysis,Meta-analysis of all the randomized and observational studies revealed a significant decrease in h HF with SGLT2 i.This study helps further characterize the potential benefits and harms of SGLT2 i in routine clinical practice to complement evidence from clinical trials and prior observational studies.