M3. 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-hyperglycaemic drug. SGLT-2 Inhibitor has favourably affect in Cardiovascular outcome. Nevertheless, the cardiovascular outcome of recent clinical trial of SGLT-2 Inhibitor in Type-2 Diabetes Mellitus remains unclear. We performed meta-analysis to evaluate SGLT-2 Inhibitor in type-2 Diabetes Mellitus. Methods We performed a systematic literature search from various electronic databases. We used keywords “SGLT-2 inhibitor”, “Cardiovascular outcome”, and “Type-2 Diabetes Mellitus”. Inclusion criteria is Randomized Control Trial and 2 to 4-year follow-up. Primary endpoint is Major Adverse Cardiovascular Event (MACE). Secondary endpoints are all-cause mortality, cardiovascular mortality and hospitalization of heart failure. Outcomes is reported using Risk Ratio (RR) with 95% Confidence Interval. Results Total of four Randomized Control Trial was selected (EMPA-REG [Jardiance®], CANVAS [Invokana®], DECLARE-TIMI 58 [Forxiga®] and VERTIS-CV [Steglatro®] trial) with 42.568 patients pooled within our analysis. The results of primary outcome compared SGLT-2 Inhibitor with Placebo had significant reduction in MACE (RR = 0.93 [95% CI, 0.87–0.99], p = 0.03; I2=0%). Result of secondary outcomes showed significant reduction in all-cause mortality (RR = 0.86 [95% CI, 0.75–0.99], p = 0.03; I2=65%) and hospitalization of heart failure (RR = 0.71 [95% CI, 0.63–0.80], p < 0.00001; I2=0%), however, no significant reduction in cardiovascular mortality (RR = 0.85 [95% CI, 0.69–1.05], p = 0.13; I2=73%). Conclusion SGLT-2 Inhibitor in Type-2 Diabetes Mellitus has significant reduction in MACE, all-cause mortality, and hospitalization of heart failure. However, no significant reduction was found in cardiovascular mortality within 2 to 4-year follow-up.