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image of Sodium-Glucose Co-transporter-2 Inhibitors and Cardiac Function Parameters: A Network Meta-analysis and Trial Sequential Analysis of Randomized Clinical Trials

Abstract

Background

Sodium-glucose Co-transporter-2 Inhibitors (SGLT2is) are recommended for heart failure based on clinical outcomes. However, there is a lack of evidence linking SGLT2is with changes in cardiac function parameters.

Aim

This study aimed to systematically evaluate the literature assessing the impact of SGLT2is on various cardiac parameters.

Methods

Randomized clinical trials assessing any of the cardiac function parameters (atrial, valvular, pulmonary artery, and left ventricular) with SGLT2is were included. Mixed treatment comparison pooled estimates (mean differences (MD); 95% confidence intervals (95% CI)) were generated using a random-effects model and validated using trial sequential and bootstrap analyses. Intraclass differences and sub-group analysis in heart failure were evaluated.

Results

Thirty-four studies (2930 participants) were included in the review, of which 31 (2616 participants) were included in the meta-analysis. SGLT2is were associated with a significant increase in left ventricular ejection fraction (MD: 0.73; 95% CI: 0.09, 1.37%) and reductions in left ventricular mass (MD: -0.21; 95% CI: -0.39, -0.03 g), left ventricular mass index (MD: -0.22; 95% CI: -0.36, -0.08 g/m2), left ventricular end-diastolic diameter (MD: -0.71; 95% CI: -1.29, -0.13 cm), left ventricular end-diastolic volume (MD: -0.56; 95% CI: -1.02, -0.1 ml), left atrial volume index (MD: -0.35; 95% CI: -0.58, -0.04 ml/m2), and pulmonary artery systolic pressure (MD: -1.08; 95% CI: -1.94, -0.21 mmHg). Significant improvements in various cardiac parameters were observed in studies conducted on heart failure.

Conclusion

The findings of this study assessing cardiac function parameters support the guidelines recommending SGLT2 inhibitors in heart failure, which are primarily based on clinical outcomes.

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2025-06-16
2025-09-29

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Sodium-Glucose Co-transporter-2 Inhibitors and Cardiac Function Parameters: A Network Meta-analysis and Trial Sequential Analysis of Randomized Clinical Trials
Bentham Science Publishers ; https://doi.org/10.2174/0127724328337478250604061355
/content/journals/crcep/10.2174/0127724328337478250604061355
/content/journals/crcep/10.2174/0127724328337478250604061355
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  • Article Type:     Research Article
Keywords: clinical outcomes ; SGLT2i ; left ventricular ejection fraction ; heart failure ; trial sequential analysis ; NMA

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