Evidence mapPaperPMID 38859642Full record

ArticleKorean circulation journal2024

Cardiovascular Outcomes of Sodium-Glucose Cotransporter-2 Inhibitors Therapy in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Systematic Review and Updated Meta-Analysis.

Nicole Felix, Mateus M Gauza, Larissa Teixeira, Maria Eduarda S Guisso, Alleh Nogueira, Caroline S Dagostin, Amanda Godoi, Sandro A G Ribeiro, Juan C Duque, José A Moura-Neto and 1 more

Abstract read
In one paragraph

Article in Korean circulation journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Nicole FelixFederal University of Campina Grande, Campina Grande, PB, Brazil.ORCID https://orcid.org/0000-0001-8174-3866
Mateus M GauzaUniversity of the Region of Joinville, Joinville, SC, Brazil.ORCID https://orcid.org/0000-0003-4133-6208
Larissa TeixeiraFederal University of Campina Grande, Campina Grande, PB, Brazil.ORCID https://orcid.org/0009-0000-7714-7148
Maria Eduarda S GuissoUniversity of the Region of Joinville, Joinville, SC, Brazil.ORCID https://orcid.org/0000-0002-7067-4372
Alleh NogueiraBahiana School of Medicine and Public Health, Salvador, BA, Brazil.ORCID https://orcid.org/0000-0001-5995-6179
Caroline S DagostinUniversity of the Extreme South of Santa Catarina, Criciúma, SC, Brazil.ORCID https://orcid.org/0000-0002-5047-4023
Amanda GodoiCardiff University School of Medicine, Cardiff, UK. amandacgodoi@gmail.com.ORCID https://orcid.org/0000-0001-8666-7786
Sandro A G RibeiroUniversity of Brasília, Brasília, DF, Brazil.ORCID https://orcid.org/0000-0001-6085-9990
Juan C DuqueKatz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miami, FL, USA.ORCID https://orcid.org/0000-0001-7419-7342
José A Moura-NetoBahiana School of Medicine and Public Health, Salvador, BA, Brazil.ORCID https://orcid.org/0000-0003-1339-3731
Rhanderson CardosoBrigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.ORCID https://orcid.org/0000-0003-3622-7605

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) may depend on renal function, and this raises theoretical concern over its effects on cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD).

methodsThis systematic review and updated meta-analysis of randomized controlled trials (RCTs) compared cardiovascular outcomes of patients with T2DM and CKD treated with SGLT2i to placebo. PubMed, Embase, and Cochrane were systematically searched. Prespecified subgroup analyses were performed in strata of estimated glomerular filtration rate (eGFR) of <45 mL/min/1.73 m² and 45 to 59 mL/min/1.73 m².

resultsNine RCTs comprising 29,146 patients were selected. Average follow-up ranged from 0.75 to 4.2 years. SGLT2i were shown to reduce the risk of all-cause mortality (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79-0.97; p=0.01), the composite of cardiovascular mortality or hospitalizations for heart failure (HHF: HR, 0.71; 95% CI, 0.65-0.78; p<0.001), cardiovascular mortality (HR, 0.86; 95% CI, 0.76-0.98; p=0.02), HHF (HR, 0.62; 95% CI, 0.55-0.71; p<0.001), major adverse cardiovascular events (HR, 0.85; 95% CI, 0.77-0.94; p=0.002), stroke (HR, 0.76; 95% CI, 0.59-0.97; p=0.03), and myocardial infarction (HR, 0.78; 95% CI, 0.67-0.91; p=0.001). These findings were consistent over strata of eGFR, albeit with a lower incidence of stroke in patients treated with SGLT2i with eGFR <45 mL/min/1.73 m² (p-value for interaction=0.04).

conclusionsCompared with a placebo, patients with T2DM and CKD treated with SGLT2i experience a reduction in all-cause mortality, cardiovascular mortality, and HHF.

trial registrationPROSPERO Identifier: CRD42023401081.

Indexed as

Chronic kidney diseaseDiabetes mellitus, type 2Heart failureHospitalizationSGLT2 inhibitors

Identifiers

PMID38859642
PMCPMC11361773

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.