M18. Three-year cardiovascular outcome of SGLT-2 Inhibitor in patient with Type 2 Diabetes Mellitus: a Meta-Analysis of Randomized Control Trial

Abstract

Abstract Aims SGLT-2 Inhibitor is an anti-diabetic drug. SGLT-2 Inhibitor has favourably effect in cardiovascular outcomes. However, the three-year cardiovascular outcomes of SGLT-2 Inhibitor in Type-2 Diabetes Mellitus remains unclear. We performed meta-analysis to evaluate cardiovascular outcomes in three-years of SGLT-2 Inhibitor therapy. Methods We performed a systematic literature search from various electronic databases. We used keywords “SGLT-2 Inhibitor”, “Type-2 Diabetes Mellitus”, and “Cardiovascular outcome”. Inclusion criteria for research is Randomized Control Trial and 3-year follow-up. Primary endpoint is Major Adverse Cardiovascular Event (MACE). Secondary endpoints are all-cause mortality, cardiovascular mortality and hospitalization of heart failure. Risk ratio (RR) with 95% confidence interval were used to report all outcomes. Results Total of two Randomized Control Trial was selected (EMPA-REG [Jardiance®] and VERTIS-CV [Steglatro®] trial) with 15.266 patients pooled in our analysis. Results of three-year primary outcome compared SGLT-2 Inhibitor with Placebo had no significant reduction in MACE (RR = 0.93 [95% CI, 0.81–1.07], p = 0.32; I2=56%). Result of secondary outcome showed no significant reduction in all-cause mortality (RR = 0.80 [95% CI, 0.60-1.08], p = 0.15; I2=85%) and cardiovascular mortality (RR = 0.77 [95% CI, 0.52–1.12], p = 0.17; I2=87%). However, there are significant reduction in hospitalization of heart failure (RR = 0.68 [95% CI, 0.57–0.82], p < 0.00001; I2=0%). Conclusion SGLT-2 Inhibitor in Type-2 Diabetes Mellitus has significant reduction in hospitalization of heart failure. However, no significant results were found in MACE, all-cause mortality, and cardiovascular mortality after 3-year follow-up.