Abstract Body (Do not enter title and authors here): Background:
SGLT2 inhibitors improve cardiovascular outcomes in patients with heart failure and chronic kidney disease. However, the evidence on their efficacy in patients who have had acute myocardial infarction is still lacking. This systematic review and meta-analysis aimed to assess the safety and efficacy of SGLT2 inhibitors on cardiovascular outcomes in patients with a recent acute myocardial infarction.
Methods:
We searched various electronic databases including MEDLINE (via PubMed), Embase, the Cochrane Library, and Clincaltrials.gov to retrieve randomized controlled trials comparing SGLT2 inhibitors to placebo in patients with acute myocardial infarction. We performed statistical analysis on RevMan 5.4 using the random effect model. We reported dichotomous outcomes as relative risk (RR) along with 95% confidence intervals (CI) and continuous outcomes as mean difference (MD) along with 95% CI.
Results:
Our meta-analysis included 6 RCTs involving 11,256 patients. SGLT2i significantly decreased the rate of hospitalization for heart failure (RR 0.73, 95% CI: 0.61-0.88, I2=0%) with no significant change in mortality (RR 1.05, 95% CI: 0.78-1.40, I2=25%). There was no significant change between the two groups when assessing the rate of all-cause hospitalization (RR 1.00, 95% CI: 0.84-1.17, I2=%), cardiovascular death (RR 1.03, 95% CI: 0.83-1.28, I2=%), hepatic injury (RR 1.99, 95% CI: 0.54-7.40, I2=%), ketoacidosis (RR 2.00, 95% CI: 0.18-22.01, I2=%), hypoglycemia (RR 0.80, 95% CI: 0.21-2.97, I2=%), or lower limb amputation (RR 1.80, 95% CI: 0.60-5.36, I2=%). The mean change in NT-pro BNP (MD -0.28 95% CI: -0.61-0.05, I2=0%] and LVEF at follow-up (MD 0.62, 95% CI -0.73-1.97, I2=0%] were also comparable between the two groups.
Conclusion
SGLT2i reduces the rate of hospitalization for heart failure with no change in mortality or other cardiovascular outcomes. Further high-quality and large-scale RCTs are required to confirm or refute our findings and provide more reliable results.