A comprehensive analysis presented at the American College of Cardiology Annual Scientific Session & Expo, and published in the journal Circulation, has provided strong evidence that a class of diabetes medication, known as sodium glucose co-transporter 2 (SGLT2) inhibitors, offers significant cardiovascular benefits to patients.
This group of drugs, also referred to as gliflozins, works by lowering blood glucose levels through increased excretion in the urine.
Previously, the impact of SGLT2 inhibitors on heart failure and kidney health had been established through various studies.
However, their effect on major adverse cardiovascular events (MACE)—which include cardiovascular death, heart attacks (myocardial infarction), and strokes—had remained somewhat unclear.
This new meta-analysis sheds light on these effects by examining data from 11 trials that included a total of 78,607 patients suffering from diabetes, heart failure, or chronic kidney disease (CKD).
The findings revealed a 9% overall reduction in the risk of MACE and a 14% reduction in cardiovascular deaths among those treated with SGLT2 inhibitors compared to placebo.
Notably, the reduction in MACE was primarily due to a decrease in the rates of heart failure death and sudden cardiac death, with no significant effects observed on the rates of myocardial infarction or stroke.
Dr. Brendon Neuen, Senior Research Fellow at The George Institute for Global Health and one of the authors of the study, highlighted the importance of these results.
He pointed out that while individual trials of SGLT2 inhibitors had shown some cardiovascular benefits, the specific effects on different types of cardiovascular events across major patient subgroups had remained uncertain until now.
The analysis demonstrated a consistent beneficial effect of SGLT2 inhibitors across diverse groups of patients, regardless of their specific conditions such as existing atherosclerotic cardiovascular disease (ASCVD), previous heart attacks, diabetes, prior heart failure, or varying levels of kidney function.
Diabetes is well recognized as a risk factor for both cardiovascular and kidney diseases, primarily due to the damage high blood sugar levels can cause to blood vessels. Many individuals with diabetes also suffer from ASCVD, CKD, or heart failure, especially as they age.
Despite the proven benefits of SGLT2 inhibitors on heart, kidney, and metabolic health, Dr. Neuen noted that these medications are still underutilized.
He expressed hope that the findings from this meta-analysis would lead to more tailored and frequent use of these drugs, particularly among patients with coexisting conditions like diabetes and heart failure or CKD, who stand to gain multiple health benefits from the treatment.
The study underscores the potential of SGLT2 inhibitors to significantly improve the cardiovascular outcomes of patients with diabetes and related conditions, advocating for broader adoption in clinical practice.
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The research findings can be found in Circulation.
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