The following is a summary of “Cardiovascular Outcomes With Empagliflozin and Dapagliflozin in Patients Without Diabetes,” published in the February 2024 issue of Cardiology by Singh et al.

SGLT2i (sodium-glucose cotransporter-2 inhibitors) are widely used to provide cardiovascular health benefits in patients with diabetes melitus (DM). However, their effect on patients without diabetes is not well recorded. 

Researchers conducted a retrospective study to derive the efficacy of SGLT2i on patients without DM. 

They scoured online databases for relevant RCTs and compiled data from six trials, covering nearly 12,984 patients (6,501 in SGLTwi and 6,483 in the placebo group). These trials spanned an average duration of about 17.7 months and compared SGLT2i to a placebo or control group. The primary endpoint of this study was death/hospitalization for heart failure, all-cause mortality, and serious adverse events. 

The results showed that 4 RCTs out of 6 had patients with HF, 1 with CKD, and 1 with myocardial infarction. With a mean age of 64 years, 72% of patients were men, and the mean hemoglobin A1C was 5.7%. When compared with placebo, SGLT2i had a significantly lower risk of either dying from heart problems or being hospitalized for HF (OR 0.77, 95%% CI 0.68 to 0.87, P<0.0001), primarily due to a decrease in hospitalization for HF (OR 0.70, 95% CI 0.60 to 0.81, P<0.00001). No differences in cardiovascular death (OR 0.86, 95% CI 0.74 to 1.01, P=0.06), all-cause mortality (OR 0.89, 95% CI 0.71 to 1.11, P=0.29), and major adverse events (OR 0.95, 95% CI 0.68 to 1.32, P=0.75) were found and serious adverse events were also lower with use of empagliflozin vs placebo.

Investigators concluded that SGLT2i had significant benefits for reducing CV death hospitalization for HF in patients without DM. However, underlying comorbidities need to be considered before interpreting the results. 

Source: ajconline.org/article/S0002-9149(24)00161-9/fulltext#%20