To evaluate the cardiovascular (CV) benefits of sodium-glucose co-transporter 2 (SGLT-2) inhibitors according to 1) patient history of heart failure (HF) and 2) severity of left ventricular ejection fraction (LVEF) reduction in HF with reduced ejection fraction (HFrEF), researchers conducted a meta-analysis, searching all randomized, placebo-controlled trials of SGLT-2 inhibitors reporting similar CV outcomes from January 1, 2010 to July 1, 2021. The primary outcome was the composite of hospitalization for HF or CV death. Secondary outcomes included the single components of the primary outcome and all-cause mortality. A severely reduced LVEF in HFrEF was defined as ≤30% to 35%, depending on the original study definition.

Data from eight trials and a total of 56,665 patients (n = 31,609 SGLT-2 group; n = 24,056, placebo group) were included. SGLT-2 inhibitors were found to significantly improved CV outcomes and reduced all-cause mortality in patients both with and without a history of HF. Furthermore, patients with HFrEF had improved CV outcomes with SGLT-2 inhibitors irrespective of LVEF reduction. “SGLT-2 inhibitors are a groundbreaking therapy for the treatment of CV disease and have significant benefits for patients with HRrEF, regardless of diabetic status,” the study authors noted.