Cardiovascular Effects of SGLT2 Inhibitors

Sodium–glucose cotransporter 2 (SGLT2) inhibitors, which were developed to treat diabetes, appear to reduce the risk for adverse cardiovascular events. Now, with the publication of DECLARE–TIMI 58 (NEJM JW Cardiol Nov 10 2018; [e-pub] and N Engl J Med 2018 Nov 10; [e-pub]), there are three major randomized, placebo-controlled, cardiovascular outcome trials of SGLT2 inhibitors in patients with type 2 diabetes; investigators conducted a systematic review and meta-analysis of these trials. EMPA–REG OUTCOME, which studied empagliflozin, enrolled 7020 people (100% with cardiovascular disease [CVD]); the CANVAS Program, which studied canagliflozin, enrolled 10,142 (66% with CVD); and DECLARE–TIMI 58, which studied dapagliflozin, enrolled 17,160 (…