Evidence mapPaperPMID 40955256Full record

ReviewCureus2025

Empagliflozin and Cardiovascular Outcomes: A Systematic Review of Randomized Controlled Trials in Populations With Diabetes and Heart Failure.

Farrukh Ansar, Abdullah Azzam, Usman Zafar, Sabeeh Ahmed, Fatima K Ghauri, AbdulRehman M Khan, Abdul Rafay Mehmood Khan, Muhammad Umair Khalil, Hamdah Iftikhar, Abdul Rehman Faiz and 1 more

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 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
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.

Farrukh AnsarDepartment of Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Abdullah AzzamDepartment of Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Usman ZafarDepartment of Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Sabeeh AhmedDepartment of Neurology, National Hospital for Neurology and Neurosurgery, London, GBR.
Fatima K GhauriDepartment of Medicine, Bahawal Victoria Hospital, Bahawalpur, PAK.
AbdulRehman M KhanDepartment of Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Abdul Rafay Mehmood KhanDepartment of Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Muhammad Umair KhalilDepartment of Psychiatry, Oxleas NHS Foundation Trust, London, GBR.
Hamdah IftikharDepartment of Medicine, Hazrat Bari Imam Sarkar (HBS) General Hospital, Islamabad, PAK.
Abdul Rehman FaizDepartment of Emergency Medicine, Quaid-e-Azam International Hospital, Islamabad, PAK.
Muhammad Bilal AhmadDepartment of Medicine, Quaid-e-Azam International Hospital, Islamabad, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cardiovascular disease is a principal cause of morbidity and mortality worldwide, disproportionately affecting individuals with type 2 diabetes mellitus (T2DM) and heart failure. Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, has shown promising cardioprotective effects beyond its glucose-lowering properties. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, involving a comprehensive literature search of PubMed, Scopus, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to May 2025. Randomized controlled trials evaluating empagliflozin in adult patients with T2DM or heart failure and reporting cardiovascular outcomes were included. A total of 13 RCTs comprising 21,669 participants were synthesized, encompassing a broad spectrum of populations, including high-risk T2DM, chronic heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), and post-myocardial infarction cohorts. Empagliflozin was consistently associated with significant reductions in major adverse cardiovascular events, notably a 14-38% reduction in cardiovascular mortality and a 23-35% reduction in heart failure hospitalizations across key trials, such as EMPA-REG OUTCOME, EMPEROR-Reduced, and EMPEROR-Preserved. Smaller mechanistic studies highlighted additional benefits, including improvements in left ventricular function, cardiac remodeling, exercise capacity, and hemodynamic parameters. The safety profile of empagliflozin was favorable, with the main adverse event being an increased incidence of mild genital infections, and no excess in severe adverse or hypoglycemic events. Despite some heterogeneity in trial populations and follow-up, current evidence robustly supports empagliflozin as an effective and safe strategy to reduce cardiovascular risk in patients with T2DM and heart failure. Further research is warranted to explore long-term outcomes and expand indications to broader patient populations.

Indexed as

a systematic reviewcardiovascular outcomesempagliflozinheart failuretype 2 diabetes

Identifiers

PMID40955256
PMCPMC12433617

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.