LAUSR

Large cardiovascular (CV) outcome trials demonstrated sodium glucose cotransporter 2 inhibitors (SGLT2is) could significantly reduce cardiorenal events in type 2 diabetic adults. However, the effects of SGLT2is on cardiorenal endpoints in many diabetic subpopulations are undefined because of the following two main reasons. First, the effects of baseline characteristics on cardiorenal events reduced by SGLT2is are controversial across different trials. For instance, most trials showed the effects of baseline characteristics on major adverse cardiovascular events (MACE) reduced by SGLT2is were not significant, whereas some trials revealed the significant effects of duration of diabetes [1], beta-blocker and diuretic use [2], and age and glycated hemoglobin [3] on MACE reduced by SGLT2is in type 2 diabetes. Second, individual trials do not have enough statistical power to evaluate the effects of SGLT2is in some diabetic subpopulations. For instance, dapagliflozin [1] was not observed to significantly reduce CV death or hospitalization for heart failure (HHF) in most diabetic subgroups defined by region, while canagliflozin [4] was not observed to significantly reduce renal composite endpoint in diabetic patients with an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m. Therefore, we conducted this meta-analysis to assess the efficacy of SGLT2is on three critical endpoints (i.e., MACE, CV death or HHF, and renal composite endpoint) in various diabetic subgroups defined by 17 factors.