Abstract
The association between sodium-glucose cotransporter 2 inhibitors (SGLT2is) and various cardiovascular and respiratory diseases is unestablished. This meta-analysis aimed to explore whether use of SGLT2is is significantly associated with the occurrences of 80 types of cardiovascular diseases and 55 types of respiratory diseases. Large randomized trials of SGLT2is were included in analysis. Meta-analysis was conducted to synthesize risk ratio (RR) and 95% confidence interval (CI). Nine large trials were included in analysis. Compared to placebo, SGLT2is were associated with the reduced risks of 9 types of cardiovascular diseases (e.g., atrial fibrillation [RR 0.78, 95% CI 0.67-0.91], bradycardia [RR 0.60, 95% CI 0.40-0.89], and hypertensive emergency [RR 0.29, 95% CI 0.12-0.72]) and 11 types of respiratory diseases (e.g., chronic obstructive pulmonary disease [RR 0.77, 95% CI 0.61-0.97], asthma [RR 0.57, 95% CI 0.35-0.95], and sleep apnoea syndrome [RR 0.36, 95% CI 0.15-0.87]). The results of random-effects meta-analysis were similar with those of fixed-effects meta-analysis. No heterogeneity or only little heterogeneity was found in most meta-analyses. No publication bias was observed in most of the meta-analyses conducted in this study. SGLT2is were not significantly associated with the other 115 cardiovascular and respiratory diseases. SGLT2is are associated with the reduced risks of 9 types of cardiovascular diseases (e.g., atrial fibrillation, bradycardia, and hypertensive emergency) and 11 types of respiratory diseases (e.g., chronic obstructive pulmonary disease, asthma, and sleep apnoea syndrome). This proposes the potential of SGLT2is to be used for prevention of these cardiovascular and respiratory diseases.
Highlights
Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have been confirmed, by large cardiovascular outcome trials, to have the obvious efficacy in reducing arteriosclerotic cardiovascular events and heart failure events
sodium-glucose cotransporter 2 inhibitors (SGLT2is) were associated with the reduced risks of atrial fibrillation (RR 0.78, 95% confidence interval (CI) 0.67–0.91; I2 0; Peffect 0.002), bradycardia (RR 0.60, 95% CI 0.40–0.89; I2 0; Peffect 0.012), cardiac failure (RR 0.74, 95% CI 0.68–0.80; I2 0; Peffect < 0.001), cardiac failure acute (RR 0.68, 95% CI 0.53–0.87; I2 0; Peffect 0.002), cardiac failure chronic (RR 0.72, 95% CI 0.55–0.95; I2 0; Peffect 0.021), cardiac failure congestive (RR 0.74, 95% CI 0.65–0.85; I2 0; Peffect < 0.001), hypertension (RR 0.67, 95% CI 0.49–0.93; I2 20.9%; Peffect 0.015), hypertensive emergency
The results of detection of publication bias are detailed in Supplementary Figures S138–S272 in Supplementary Appendix S1), suggesting that most of the meta-analyses conducted in this study had no publication bias since most of the p values from Egger test were greater than 0.05. This is the first meta-analysis that assessed in detail the association between use of SGLT2is and the occurrence of various cardiovascular and respiratory diseases. It revealed that use of SGLT2is was associated with the reduced risks of nine types of cardiovascular diseases and 11 types of respiratory diseases
Summary
Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have been confirmed, by large cardiovascular outcome trials, to have the obvious efficacy in reducing arteriosclerotic cardiovascular events and heart failure events. There are no large randomized trials which have aimed to assess the impact of SGLT2is on the occurrences of various cardiovascular and respiratory diseases, those trials focusing on the cardiorenal endpoints with SGLT2is reported in detail the occurrences of various serious adverse events (SAEs), which included the occurrences of various cardiovascular and respiratory diseases. These data of SAEs make it possible to evaluate the association between use of SGLT2is and the occurrences of various cardiovascular and respiratory diseases. We intended to, based on the SAEs data from the large cardiorenal outcome trials of SGLT2is, conduct a meta-analysis to explore whether use of SGLT2is is significantly associated with the occurrences of various cardiovascular and respiratory diseases
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
