PMID- 34964748
OWN - NLM
STAT- MEDLINE
DCOM- 20220201
LR  - 20230103
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 47
DP  - 2021 Nov 24
TI  - Impact of demographic characteristics and antihyperglycemic and cardiovascular 
      drugs on the cardiorenal benefits of SGLT2 inhibitors in patients with type 2 
      diabetes mellitus: A protocol for systematic review and meta-analysis.
PG  - e27802
LID - 10.1097/MD.0000000000027802 [doi]
LID - e27802
AB  - BACKGROUND: It is unclear whether demographic characteristics and baseline use of 
      hypoglycemic and cardiovascular drugs significantly affect the efficacy of 
      sodium-glucose transporter 2 (SGLT2) inhibitors on cardiorenal outcomes in 
      patients with type 2 diabetes mellitus (T2DM). METHODS: Randomized trials 
      assessing the efficacy of SGLT2 inhibitors on cardiorenal outcomes in adult 
      patients with T2DM were included in analysis. Three endpoints of interest were 
      major adverse cardiovascular events (MACE), hospitalization for heart failure or 
      cardiovascular death (HHF or CV death), and kidney composite outcome (KCO). We 
      performed random-effects meta-analysis using the aggregate data of hazard ratios 
      (HRs) and 95% confidence intervals (CIs). Subgroup analyses were done according 
      to 17 factors of interest, including 7 factors related to demographic 
      characteristics and 10 related to baseline use of antihyperglycemic and 
      cardiovascular drugs such as renin-angiotensin system (RAS) inhibitor. We 
      conducted meta-regression analyses to calculate P values for subgroup 
      differences. RESULTS: Seven trials were included in this meta-analysis. Compared 
      with placebo, SGLT2 inhibitors significantly lowered the risk of MACE (HR 0.90, 
      95% CI 0.84-0.97) regardless of demographic characteristics and baseline use of 
      insulin, statin or ezetimibe, RAS inhibitor, beta-blocker, and diuretic 
      (Psubgroup from 0.088-0.981); that of HHF or CV death (HR 0.78, 95% CI 0.71-0.85) 
      regardless of demographic characteristics and baseline use of 10 
      antihyperglycemic and cardiovascular drugs (Psubgroup from 0.147-0.999); and that 
      of KCO (HR 0.63, 95% CI 0.57-0.69) regardless of demographic characteristics and 
      baseline use of statin or ezetimibe, RAS inhibitor, and diuretic (Psubgroup from 
      0.073-0.918). CONCLUSIONS: The cardiorenal benefits of SGLT2 inhibitors were 
      consistent in a broad population of T2DM patients. The findings of this 
      meta-analysis suggest that SGLT2 inhibitors should be recommended in T2DM 
      patients for the prevention of cardiorenal events, regardless of various 
      demographic characteristics and baseline use of various hypoglycemic and 
      cardiovascular drugs.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Chang, Rong
AU  - Chang R
AD  - Cardiovascular Department, Shenzhen Longhua District Central Hospital, Shenzhen, 
      China.
FAU - Liu, Shu-Yan
AU  - Liu SY
AUID- ORCID: 0000-0001-9345-0825
AD  - Department of Endocrinology, The Second Affiliated Hospital of Kunming Medical 
      University, Kunming, China.
FAU - Zhao, Li-Min
AU  - Zhao LM
AD  - Department of General Medicine, Shenzhen Longhua District Central Hospital, 
      Shenzhen, China.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Cardiovascular Agents)
RN  - 0 (Diuretics)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - EOR26LQQ24 (Ezetimibe)
SB  - IM
MH  - Cardiovascular Agents/*therapeutic use
MH  - Cardiovascular Diseases/*prevention & control
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Diuretics/therapeutic use
MH  - Ezetimibe
MH  - Heart Failure
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Meta-Analysis as Topic
MH  - Socioeconomic Factors
MH  - Sodium-Glucose Transporter 2 Inhibitors/*therapeutic use
MH  - Systematic Reviews as Topic
PMC - PMC8615349
COIS- The authors have no funding and conflicts of interests to disclose.
EDAT- 2021/12/30 06:00
MHDA- 2022/02/02 06:00
PMCR- 2021/11/24
CRDT- 2021/12/29 12:22
PHST- 2021/05/25 00:00 [received]
PHST- 2021/10/26 00:00 [accepted]
PHST- 2021/12/29 12:22 [entrez]
PHST- 2021/12/30 06:00 [pubmed]
PHST- 2022/02/02 06:00 [medline]
PHST- 2021/11/24 00:00 [pmc-release]
AID - 00005792-202111240-00023 [pii]
AID - MD-D-21-03813 [pii]
AID - 10.1097/MD.0000000000027802 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Nov 24;100(47):e27802. doi: 
      10.1097/MD.0000000000027802.