Sodium-glucose cotransporter 2 inhibitor in heart failure patients and their outcomes: A meta-analysis of randomized controlled trials

doi:10.4330/wjc.v17.i10.109731

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World Journal of Cardiology

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1949-8462

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Meta-Analysis

World J Cardiol. Oct 26, 2025; 17(10): 109731
Published online Oct 26, 2025. doi: 10.4330/wjc.v17.i10.109731

Table 1 Baseline demographics of subjects in each trial included in our study, mean ± SD/median (25^th-75^th percentiles)

Type of SGLT2 inhibitor	DAPA-HF		DECLARE-TIMI 58		DELIVER trial		EMPA-REG outcome
Type of SGLT2 inhibitor	Dapagliflozin	Placebo	Dapagliflozin	Placebo	Dapagliflozin	Placebo	Empagliflozin	Placebo
HF patients	4744		1987		6263		706
Drug group	2373	2371	980	1007	3131	3132	462	244
Age (years)	66.2 (11)	66.5 (10.8)	64 (59-69)		71.8 (9.6)	71.5 (9.5)	64.5 (8.8)	64.5 (8.9)
Female (%)	23.8	23	33.7		43.6	44.2	30.7	28.3
BMI (kg/m²)	28.2 (6)	28.1 (5.9)	32.6 (29.1-37.1)		29.8 (6.2)	29.9 (6.1)	31.9 (5.6)	32.3 (5.4)
White (%)	70	70.5			70.7	71	81.4	82
Black (%)	5.1	4.4			2.6	2.5	7.1	7
Asian (%)	23.3	23.8			20.1	20.6	11.3	10.2
other (%)	1.6	1.3			6.6	5.9	0.2	0.8
NYHA II (%)	67.7	67.4	56.1		73.9	76.6
NYHA III (%)	31.5	31.7	7.8		25.8	23.1
NYHA IV (%)	0.8	1	0.5		0.3	0.3
LVEF (%)	31.2 (6.7)	30.9 (6.9)	49 (43-54)		54 (8.6)	54.3 (8.9)
T2DM (%)	41.8	41.8	100		44.7	44.9	100	100
HTN (%)	72.6	72.2	92.9		88	89.3	98.7	99.2
CAD (%)	42.2	43.4	89.8		29.8	30.8	83.3	85.7
AF/flutter (%)	38.6	38			56.1	57.3	16.5	17.6
Loop diuretic (%)	93.4	93.5	38.8		76.7	76.9	48.5	45.1
Beta blocker (%)	96	96.2	80.8		82.8	82.5	77.9	81.6
ACEi (%)	56.1	56.1			36.5	36.7
ARB (%)	28.4	26.7			36.2	36.4
ACEi or ARB (%)			86.2				87.9	84.4
ARNI (%)	10.5	10.9			5.3	4.3	0.6	0.4
MRA (%)	71.5	70.6	19.4		42.8	42.4	25.1	21.7

HF: Heart failure; BMI: Body mass index; NYHA: New York heart association; LVEF: Left ventricular ejection fraction; T2DM: Type 2 diabetes mellites; HTN: Hypertension; CAD: Coronary artery disease; AF: Atrial fibrillation; ARBs: Angiotensin receptor blockers; ACEi: Angiotensin-converting enzyme inhibitors; ARNI: Angiotensin receptor/neprilysin inhibitor; MRA: Mineralocorticoid receptor antagonists.

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Table 2 Baseline demographics of subjects in each trial included in our study, mean ± SD/median (25^th-75^th percentiles)

Type of SGLT2 inhibitor	EMPEROR-preserved		EMPEROR-reduced		EMPULSE		SOLOIST-WHF		VERTIS-CV
Type of SGLT2 inhibitor	Empagliflozin	Placebo	Empagliflozin	Placebo	Empagliflozin	Placebo	Sotagliflozin	Placebo	Ertugliflozin	Placebo
HF patients	5988		3730		530		1222		1958
Drug group	2997	2991	1863	1867	265	265	608	614	1286	672
Age (years)	71.8 (9.3)	71.9 (9.6)	67.2 (10.8)	66.5 (11.2)	71 (62-78)	70 (59-78)	69 (63-76)	70 (64-76)	64.2 (7.9)	64.7 (7.8)
Female (%)	44.6	44.7	23.5	24.4	32.5	35.1	32.6	34.9	30.7	34.1
BMI (kg/m²)	29.77 (5.8)	29.9 (5.9)	28 (5.5)	27.8 (5.3)	28.3 (24.5-32.5)	29.1 (24.7-33.6)	30.4 (26.3-34.3)	31.1 (27.3-34.5)	32.5 (5.5)	32.7 (5.2)
White (%)	76.3	75.4	71.1	69.8	79.6	76.2	93.3	93.2
Black (%)	4.4	4.2	6.6	7.2	7.9	12.5	4.1	4.1
Asian (%)	13.8	13.7	18.1	17.9	12.1	9.4	1.3	1.1
Other (%)	5.5	6.7	4.2	5	0.4	1.5	1.3	1.7
NYHA II (%)	81.1	81.9	75.1	75	35.8	34.3	45.2		65.2	67.1
NYHA III (%)	18.4	17.8	24.4	24.4	50.6	54.7	45.8		7.9	5.5
NYHA IV (%)	0.3	0.3	0.5	0.6	9.8	8.7	4.4		0.1	0
LVEF (%)	54.3 (8.8)	54.3 (8.8)	27.7 (6)	27.2 (6.1)	31 (23-45)	32 (22.5-49)	35 (28-47)	35 (28-45)
T2DM (%)	48.9	49.2	49.8	49.8	46.8	43.8	100	100
HTN (%)	90.8	90.4	72.4	72.3	77.4	83.4			93.2	93.9
CAD (%)	35		45.0	41.9	29.4	29.4			83.7	84.1
AF/flutter (%)	51.5	50.6	37.7	39.5	50.6	48.3
Loop diuretic (%)	77.4	77.5	84.8	85.4	87.9	77	95.4	94.6	28.9	30.8
Beta blocker (%)	86.7	85.9	94.7	94.7	80.4	78.5	92.8	91.4	78.7	79.9
ACEi (%)	40.2				33.2	33.6	41.8	39.3
ARB (%)	38.7				24.2	19.6	40.3	44
ACEi or ARB (%)			70.5	68.9
ARNI (%)	2.2	2.3	18.3	20.7	13.6	17	15.3	18.2
MRA (%)	37.3	37.6	70.1	72.6	57	47.2	66.3	62.7	19.7	16.8

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Table 3 Egger’s regression test and publication bias

Outcomes	Hospitalization for HF	Cardiovascular deaths	All-cause mortality
Intercept	-0.1782	-0.03214	-1.3577
95%CI	-1.4307 to 1.0742	-1.5346 to 1.4704	-2.7718 to 0.05639
Significance level	P = 0.7396	P = 0.96	P = 0.0575

HF: Heart failure.

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Citation: Parsi S, Shirsat PD, Mahali LP, Surani S, Kashyap R. Sodium-glucose cotransporter 2 inhibitor in heart failure patients and their outcomes: A meta-analysis of randomized controlled trials. World J Cardiol 2025; 17(10): 109731
URL: https://www.wjgnet.com/1949-8462/full/v17/i10/109731.htm
DOI: https://dx.doi.org/10.4330/wjc.v17.i10.109731