Sodium-Glucose Cotransporter-2 Inhibitors Following Acute Myocardial Infarction in Patients Without Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials
In brief
SGLT2 inhibitors cut first heart-failure hospitalization by 26% after heart attack
A meta-analysis of five randomized trials including 9,135 non-diabetic patients without prior heart failure found that SGLT2 inhibitor therapy after acute myocardial infarction reduced first heart-failure hospitalizations by roughly one quarter and raised ejection fraction by about two percentage points, while also lowering NT-proBNP levels. No effect on overall mortality was seen, so larger trials are needed to confirm cardiovascular benefits in this group.
- Journal
- Clinical Medicine Insights. Cardiology (Q2)
- Published
- 17 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Muhammad Ahmed, Muhammad Hamza Shuja, Shajia Shakil, Huzaifa Ul Haque Ansari, Firzah Shakil, Muhammad Abdullah Naveed, et al.
- PMID
- 42472080
- DOI
- 10.1177/11795468261469143
Why clinicians should know about it
- Picked for Cardiology and Cardiovascular Medicine (paper of the day, 20 July 2026).
Abstract
BACKGROUND: Sodium-glucose transporter 2 (SGLT2) inhibitors have shown significant cardiovascular benefits in heart failure (HF) patients with diabetes mellitus or chronic kidney disease. However, their safety and efficacy in non-diabetic patients without HF presenting with acute myocardial infarction (AMI) remain understudied. METHODS: Databases including MEDLINE, Scopus, Cochrane Library, and ClinicalTrials.gov were queried through August 2025 to identify randomized controlled trials (RCTs). Data were pooled using a random-effects model using risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI). RESULTS: Five RCTs involving 9,135 patients (SGLT2i: 4,581 and placebo: 4,554) were included. On pooled analysis, SGLT2 inhibitors were associated with significantly reduced first HF hospitalization (RR: 0.74, p=0.02), improved LVEF (MD: 2.08; p=0.002), and reduced NT-proBNP levels (MD: 12.81; p < 0.0001). No significant differences were noted in all-cause mortality and the composite of first HF hospitalization with all-cause mortality. CONCLUSION: In non-diabetic patients without HF, SGLT2 inhibitors significantly reduce the first HF hospitalization and improve LVEF following AMI. The findings of this meta-analysis suggest that future research should evaluate the cardiovascular benefits of SGLT2 inhibitors in this patient population.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.