Sodium-Glucose Co-transporter 2 Inhibitors and Cardiovascular Event Reduction in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis
- Journal
- European cardiology (Q1)
- Published
- 3 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Asaad Hussein, Mohammad Eisa Ali, Venkata Kanishk Yannakula, Maleeha Pandit, Pinhas Harel, George Alan Kadungamparambil, et al.
- PMID
- 42488770
- DOI
- 10.15420/ecr.2025.67
Why clinicians should know about it
- Picked for Cardiology and Cardiovascular Medicine (top studies of the week, 26 July 2026): SGLT2 inhibitors reduce CV events in HFpEF
Abstract
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a prevalent and challenging cardiovascular condition associated with high morbidity and mortality. Despite the lack of effective pharmacological treatments, recent studies have suggested that sodium-glucose co-transporter 2 inhibitors (SGLT2Is) may offer potential benefits in reducing cardiovascular events in HFpEF patients. The aim of this systematic review and meta-analysis is to assess the efficacy of SGLT2Is in reducing cardiovascular outcomes in individuals with HFpEF. METHODS: A comprehensive literature search was conducted across PubMed, Cochrane Library, Embase, and clinical trial registries for studies published up to October 2024. Randomised controlled trials (RCTs) that investigated the use of SGLT2Is in patients with HFpEF and reported on major cardiovascular outcomes were included. Data from eligible studies were pooled to calculate risk ratios (RR) and 95% CIs for the primary outcomes, including major adverse cardiovascular events (MACE) and hospitalisation for heart failure (HHF). RESULTS: Fifteen RCTs involving 12,436 patients with HFpEF were included in the meta-analysis. Treatment with SGLT2Is reduced the risk of MACE (RR=0.79, 95% CI [0.70-0.89]) and HHF (RR=0.72, 95% CI [0.65-0.87]) compared with placebo. Secondary analyses demonstrated reductions in cardiovascular mortality (RR=0.84, 95% CI [0.75-0.95]) and improvements in health-related quality of life as assessed by Kansas City Cardiomyopathy Questionnaire scores. CONCLUSION: SGLT2Is significantly reduce cardiovascular events, including HHF and MACE, in patients with HFpEF. These findings support the growing evidence for the use of SGLT2Is as a promising therapeutic option in this high-risk 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.