Evidence mapPaperPMID 40443580Full record

ReviewCureus2025

Comparative Effectiveness of Sodium-Glucose Co-transporter 2 (SGLT2) Inhibitors Versus Angiotensin Receptor-Neprilysin Inhibitors (ARNIs) in Heart Failure With Reduced Ejection Fraction: A Systematic Review.

Prem Singh, Akhil Sunkara, Fnu Muskan, Kumari Varsha Lohana, Mahnoor Khan, Shadi S Al-Deir, Tajammul Abbas

Abstract readReview
In one paragraph

Review in Cureus, 2025. 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

7 authors.

Prem SinghNeurology, Dow University of Health Sciences, Karachi, PAK.
Akhil SunkaraInternal Medicine, Government Medical College Mahbubnagar, Mahabubnagar, IND.
Fnu MuskanInternal Medicine, Peoples University of Medical and Health Sciences for Women, Nawabshah, PAK.
Kumari Varsha LohanaInternal Medicine, Peoples University of Medical and Health Sciences for Women, Nawabshah, PAK.
Mahnoor KhanMedicine and Surgery, Fazaia Medical College, Islamabad, PAK.
Shadi S Al-DeirInternal Medicine, Misr University for Science and Technology, Amman, JOR.
Tajammul AbbasInternal Medicine, Nishtar Medical University, Multan, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Heart failure with reduced ejection fraction (HFrEF) remains a major cause of morbidity and mortality worldwide, despite advancements in pharmacotherapy. Among the most significant recent developments are sodium-glucose co-transporter 2 (SGLT2) inhibitors and angiotensin receptor-neprilysin inhibitors (ARNIs), both of which have demonstrated substantial improvements in clinical outcomes. This systematic review aimed to compare the efficacy, clinical outcomes, and therapeutic value of SGLT2 inhibitors versus ARNIs while also exploring their potential synergistic effects in the treatment of HFrEF. A comprehensive literature search was conducted across PubMed, Scopus, Embase, and Cochrane Central, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included randomized controlled trials published within the last 10 years. Five high-quality studies met the strict inclusion criteria, reflecting the limited but robust available evidence. The results suggest that both drug classes are effective in reducing cardiovascular death and heart failure hospitalizations, with emerging evidence indicating that their combined use may further enhance clinical outcomes. SGLT2 inhibitors have shown consistent benefits across key endpoints, even when used alongside ARNI therapy. The review highlights favorable safety profiles for both drug classes and supports early combination therapy in suitable patient populations. Observations regarding potential synergistic effects emerged from consistent trends across studies rather than being predefined primary outcomes. These findings reinforce current guideline recommendations advocating for multidrug strategies and emphasize the need for future direct comparative trials to optimize treatment sequencing in HFrEF.

Indexed as

arnicardiovascular outcomescombination therapydapagliflozinheart failure with reduced ejection fractionhfrefrandomized controlled trialssacubitril/valsartansglt2 inhibitorssystematic review

Identifiers

PMID40443580
PMCPMC12121976

What Socratic holds

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Registered trials

None linked

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.