Evidence map›Paper›PMID 38360604›Full record

SynthesisCardiovascular diabetology2024

The effectiveness of sodium-glucose co-transporter 2 inhibitors on cardiorenal outcomes: an updated systematic review and meta-analysis.

Muhammad Usman Ali, G B John Mancini, Donna Fitzpatrick-Lewis, Kim A Connelly, Eileen O'Meara, Shelley Zieroth, Diana Sherifali

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
6.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Muhammad Usman AliDepartment of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
G B John ManciniDivision of Cardiology, Centre for Cardiovascular Innovation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Donna Fitzpatrick-LewisSchool of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
Kim A ConnellyKeenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, M5B 1W8, Canada.
Eileen O'MearaDivision of Cardiology, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada.
Shelley ZierothSection of Cardiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Diana SherifaliSchool of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada. dsherif@mcmaster.ca.
McMaster University · CAMontreal Heart Institute · CASt. Michael's Hospital · CAUniversity of British Columbia · CAUniversity of Manitoba · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 2022 Canadian Cardiovascular Society (CCS) cardiorenal guideline provided clinical recommendations on sodium-glucose co-transport 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) use. Since then, additional trials of relevance for SGLT2i have been published. This update re-evaluates the clinical recommendations for using SGLTi and their indirect comparison with existing evidence on GLP-1RA as compared to the standard of care to reduce cardiorenal morbidity and mortality.

methodsWe updated our existing search and screening of the literature from September 2021 to April 2023 for randomized controlled trials of SGLT2i and GLP-1RA with placebo control. We conducted risk of bias assessment, data extraction and updated our meta-analysis of studies with similar interventions and components. The certainty of the evidence was determined using GRADE.

resultsEvidence from three new trials and additional results from an updated existing trial on SGLT2i met our inclusion criteria after an updated search. Across all the included studies, the total sample size was 151,023 adults, with 90,943 in SGLT2i trials and 60,080 in GLP-1 RA trials. The mean age ranged from 59.9 to 68.4 years. Compared with standard care, the use of SGLT2i and GLP-1 RA showed significant reductions in the outcomes of cardiovascular (CV) mortality (14% & 13%), any-cause mortality (12% & 12%), major adverse CV events (MACE) (11% & 14%), heart failure (HF) hospitalization (30% & 9%), CV death or HF hospitalization (23% & 11%), and kidney composite outcome (32% & 22%). In participants with T2D, both classes demonstrated significant cardiorenal protection. But, only GLP-1RA showed a reduction in non-fatal stroke (16%) and only SGLT2i showed a reduction in HF hospitalization (30%) in this population of people living with T2D.

conclusionsThis updated and comprehensive meta-analysis substantiates and strengthens the clinical recommendations of the CCS cardiorenal guidelines.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Hypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsAdultAgedCanadaGlucagon-Like Peptide-1 Receptor AgonistsHeart FailureHumansMiddle AgedGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsCardiorenal outcomesGlucagon-like peptide-1 receptor agonistsMeta-analysisSodium-glucose co-transporter 2 inhibitors

Identifiers

PMID38360604
PMCPMC10870515
OpenAlexW4391839719

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.