The Effects of SGLT2 Inhibitors on Cardiovascular Outcome and Renal Disease in Type 2 Diabetic Patients Established Cardiovascular Disease and Moderate Chronic Kidney Disease: Systematic Review and Meta Analysis

Background: Diabetes patients are at high risk for mortality due to cardiorenal cause. Although multiple pharmacological drugs are available but SGLT2 (sodium glucose transporter 2) inhibitors efficacy in reducing incidence of cardiovascular and renal outcome in diabetic patients with both CKD (chronic kidney disease) and established cardiovascular disease are not clearly demonstrated. This systematic review with meta-analysis will address this with following studies. Method: Studies for this meta-analysis was been searched with PubMed, Cochrane from 2010 till 2023. Studies were screened in accordance with PRISMA updated version. Statistical analysis was done in JAMOVI software. Risk ratio with 95%CI with fixed model effect was done to find the effects of SGLT2inhibitors across various studies in reducing the incidence of cardiorenal outcome. Results: In total, 8 studies were been included for this meta-analysis. Overall, 49,034 patients were been included; 27,069 participated in treatment group and 21,965 participated in control group. Across 8 studies, mean age is 63, mean follow-up was 2.6 years. overall, there was significant reduction in CV outcome with fixed effect model -0.1482, p = 0.0008 (95% CI: -0.2345 to -0.0618). In addition, SGLT2 inhibitors has reduced risk of all cause death -0.1203 (95% CI: -0.1869 to -0.0536), hospitalization for heart failure -0.3851 (95% CI: -0.4623 to -0.3078) and composite renal outcome -0.4170 (95% CI: -0.5347 to -0.2994) with minimal risk of heterogeneity. Conclusion: The result of this systematic review suggests that SGLT2 inhibitors have significant efficacy in reducing the incident of cardiovascular death and composite renal outcome which proves the protective role of drug in both established cardiovascular disease and moderate CKD patients in type 2 diabetes.