Evidence map›Paper›PMID 38583093›Full record

SynthesisCirculation2024

Sodium-Glucose Cotransporter-2 Inhibitors and Major Adverse Cardiovascular Outcomes: A SMART-C Collaborative Meta-Analysis.

Siddharth M Patel, Yu Mi Kang, KyungAh Im, Brendon L Neuen, Stefan D Anker, Deepak L Bhatt, Javed Butler, David Z I Cherney, Brian L Claggett, Robert A Fletcher and 19 more

Open access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Circulation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
104citing papers in PubMed, 11 pooled it
48.6field-weighted citation impact, top 1% 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

104 citing papers in PubMed, 11 syntheses or guidelines pooled it, 136 citations in OpenAlex.

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  10. A Systematic Review and Meta-Analysis of the Safety and Efficacy of SGLT2 Inhibitors in Chronic Heart Failure in ACHD Patients.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
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44 more citing papers are in PubMed but not listed here.

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

29 authors at 17 institutions in 7 countries.

Siddharth M PatelTIMI Study Group (S.M.P., Y.M.K., K.I., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Yu Mi KangTIMI Study Group (S.M.P., Y.M.K., K.I., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.ORCID 0000-0002-6272-0666
KyungAh ImTIMI Study Group (S.M.P., Y.M.K., K.I., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Brendon L NeuenCardiovascular Division, Department of Medicine (S.M.P., K.I., B.L.N., B.L.C., S.D.S., M.V., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.ORCID 0000-0001-9276-8380
Stefan D AnkerBerlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charité Universitätsmedizin (S.D.A.).ORCID 0000-0002-0805-8683
Deepak L BhattMount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY (D.L.B.).ORCID 0000-0002-1278-6245
Javed ButlerBaylor Scott and White Research Institute, Dallas, TX (J.B.).ORCID 0000-0001-7683-4720
David Z I CherneyDepartment of Medicine, Division of Nephrology, Toronto General Hospital, Ontario, Canada (D.Z.I.C.).ORCID 0000-0003-4164-0429
Brian L ClaggettCardiovascular Division, Department of Medicine (S.M.P., K.I., B.L.N., B.L.C., S.D.S., M.V., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.ORCID 0000-0002-4215-9218
Robert A FletcherThe George Institute for Global Health, University of New South Wales, Sydney, Australia (B.L.N., R.A.F., M.J.J., B.N., V.P., H.J.L.H.).ORCID 0000-0002-0885-1788
William G HerringtonRenal Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (W.G.H., N.S.).ORCID 0000-0003-1172-8243
Silvio E InzucchiSection of Endocrinology, Yale School of Medicine, New Haven, CT (S.E.I.).ORCID 0000-0003-1254-6636
Meg J JardineThe George Institute for Global Health, University of New South Wales, Sydney, Australia (B.L.N., R.A.F., M.J.J., B.N., V.P., H.J.L.H.).ORCID 0000-0002-0160-2375
Kenneth W MahaffeyStanford Center for Clinical Research (SCCR), Department of Medicine, Stanford University School of Medicine, CA (K.W.M.).ORCID 0000-0002-3791-2148
Darren K McGuireUniversity of Texas Southwestern Medical Center, Parkland Health, Dallas (D.K.M.).ORCID 0000-0002-6412-7989
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, United Kingdom (J.J.V.M.).ORCID 0000-0002-6317-3975
Bruce NealThe George Institute for Global Health, University of New South Wales, Sydney, Australia (B.L.N., R.A.F., M.J.J., B.N., V.P., H.J.L.H.).ORCID 0000-0002-0490-7465
Milton PackerBaylor University Medical Center, Dallas TX(M.P.).ORCID 0000-0003-1828-2387
Vlado PerkovicThe George Institute for Global Health, University of New South Wales, Sydney, Australia (B.L.N., R.A.F., M.J.J., B.N., V.P., H.J.L.H.).ORCID 0000-0002-4257-7620
Scott D SolomonCardiovascular Division, Department of Medicine (S.M.P., K.I., B.L.N., B.L.C., S.D.S., M.V., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.ORCID 0000-0003-3698-9597
Natalie StaplinRenal Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom (W.G.H., N.S.).ORCID 0000-0003-4482-4418
Muthiah VaduganathanCardiovascular Division, Department of Medicine (S.M.P., K.I., B.L.N., B.L.C., S.D.S., M.V., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.ORCID 0000-0003-0885-1953
Christoph WannerBaylor Scott and White Research Institute, Dallas, TX (J.B.).ORCID 0000-0001-9507-5301
David C WheelerDepartment of Renal Medicine, University College London, United Kingdom (D.C.W.).ORCID 0000-0003-0745-3478
Faiez ZannadUniversité de Lorraine, Inserm Centre d'Investigations Cliniques Plurithématique 1433, and CHRU, Nancy, France (F.Z.).ORCID 0000-0001-7456-1570
Yujie ZhaoMerck & Co., Inc., Rahway, NJ (Y.Z.).ORCID 0000-0003-2896-4955
Hiddo J L HeerspinkThe George Institute for Global Health, University of New South Wales, Sydney, Australia (B.L.N., R.A.F., M.J.J., B.N., V.P., H.J.L.H.).ORCID 0000-0002-3126-3730
Marc S Sabatine *TIMI Study Group (S.M.P., Y.M.K., K.I., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.ORCID 0000-0002-0691-3359
Stephen D Wiviott *TIMI Study Group (S.M.P., Y.M.K., K.I., M.S.S., S.D.W.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.ORCID 0000-0002-4922-9880
Brigham and Women's Hospital · USThe George Institute for Global Health · AUNuffield Health · GBBaylor Scott & White Health · USBaylor University Medical Center · USBerlin-Brandenburger Centrum für Regenerative Therapien · DEBritish Heart Foundation · GBInserm · FRMerck & Co., Inc., Rahway, NJ, USA (United States) · USMount Sinai Hospital · USParkland Health & Hospital System · USStanford Medicine · USToronto General Hospital · CAUniversity College London · GBUniversity Medical Center Groningen · NLUniversity of Mississippi · USYale University · US

Funding

TRAINING PROGRAM IN CARDIOVASCULAR RESEARCHT32HL007604 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MARK W FEINBERG · 1985 to 2026
$19.0M
TRAINING GRANT IN ACADEMIC ENDOCRINOLOGYT32DK007529 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI Ursula B. Kaiser, Anand Vaidya · 1986 to 2026
$6.3M
NHLBI NIH HHS T32 HL007604NIDDK NIH HHS T32 DK007529
6 · The paper itself

Abstract

backgroundSodium-glucose cotransporter-2 inhibitors (SGLT2i) consistently improve heart failure and kidney-related outcomes; however, effects on major adverse cardiovascular events (MACE) across different patient populations are less clear.

methodsThis was a collaborative trial-level meta-analysis from the SGLT2i Meta-analysis Cardio-Renal Trialists Consortium, which includes all phase 3, placebo-controlled, outcomes trials of SGLT2i across 3 patient populations (patients with diabetes at high risk for atherosclerotic cardiovascular disease, heart failure [HF], or chronic kidney disease). The outcomes of interest were MACE (composite of cardiovascular death, myocardial infarction , or stroke), individual components of MACE (inclusive of fatal and nonfatal events), all-cause mortality, and death subtypes. Effect estimates for SGLT2i versus placebo were meta-analyzed across trials and examined across key subgroups (established atherosclerotic cardiovascular disease, previous myocardial infarction, diabetes, previous HF, albuminuria, chronic kidney disease stages, and risk groups).

resultsA total of 78 607 patients across 11 trials were included: 42 568 (54.2%), 20 725 (26.4%), and 15 314 (19.5%) were included from trials of patients with diabetes at high risk for atherosclerotic cardiovascular disease, HF, or chronic kidney disease, respectively. SGLT2i reduced the rate of MACE by 9% (hazard ration [HR], 0.91 [95% CI, 0.87-0.96],

conclusionsSGLT2i reduce the risk of MACE across a broad range of patients irrespective of atherosclerotic cardiovascular disease, diabetes, kidney function, or other major clinical characteristics at baseline. This effect is driven primarily by a reduction of cardiovascular death, particularly HF death and sudden cardiac death, without a significant effect on myocardial infarction in the overall population, and no effect on stroke. These data may help inform selection for SGLT2i therapies across the spectrum of cardiovascular-kidney-metabolic disease.

Indexed as

Cardiovascular DiseasesSodium-Glucose Transporter 2 InhibitorsAgedDiabetes Mellitus, Type 2FemaleHumansMaleRenal Insufficiency, ChronicTreatment OutcomeSodium-Glucose Transporter 2 Inhibitorsdiabetes mellitusheart failuremeta-analysismetabolic syndromerenal insufficiency, chronicsodium-glucose cotransporter-2 inhibitors

Identifiers

PMID38583093
PMCPMC11149938
OpenAlexW4394061861

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.