We also firstly found that the effect of SGLT-2i on the death from any cause have no statistical significance which has not been reported yet. Our study also has some limitations. statistical significance in type 2 diabetes individuals. Conclusion Compared with placebo, SGLT-2i may reduce the risk of heart failure hospitalization, MACE, and cardiovascular death. Therefore, SGLT-2i may be an ideal choice for type 2 diabetes mellitus patient with heart Mouse monoclonal to ICAM1 failure. These results will help inform practitioners, patients, and government bodies making appropriate choices in hypoglycemic therapy medical practice. 0.05 or the 0.05 was considered as the transmission of existence of the statistical significance heterogeneity. Funnel plots and Eggers linear regression test was used to investigate the potential publication bias (16). Results Study Characteristics and Selection Our main searches originally yielded 747 content articles, 669 papers remaining after the removal of duplicates. After reading through titles and abstracts, 6 case reports, 44 editorials, 23 characters, 133 conference papers, 262 evaluations, 26 mechanism studies, 24 animal experiments, 4 short studies, 63 unrelated studies were excluded; 84 studies remained. We examined the full texts of the remaining articles, and furtherly excluded 13 non-RCT studies, 31 literatures with irrelevant results, 22 overlapping data with the included study, 10 literatures on pilot programed design. Finally, 8 remaining studies were included in the meta-analysis ( Number 1 ) (8C11, 17C20). Characteristics of the included tests are summarized in Table 1 . In total, 55,763 AN3365 type 2 diabetes mellitus individuals were randomly assigned to receive different SGLT-2i (empagliflozin, canagliflozin, dapagliflozin) and placebo. Participants were generally middle-aged (mean age 63.0C66.4). Follow-up duration ranged from 1 to 4.2 years. Open in a separate window Number 1 Flow chart of study selection. Table 1 Demographic and medical characteristics of studies included in the meta-analysis. 0.00001) ( Number 2 ). Subgroup analyses by different providers of SGLT-2i on heart failure hospitalization showed that compared with settings, canagliflozin (RR, 0.60; 95% CI, 0.49 to 0.72; 0.00001), dapagliflozin (RR, 0.73; 95% CI AN3365 0.62 to 0.85; 0.0001), empagliflozin (RR, 0.52; 95% CI, 0.28 to 1 1.00; = 0.05) and ertugliflozin (RR, 0.70; 95% CI, 0.54 to 0.90; = 0.006) all significantly decreased the event of heart failure hospitalization in individuals with type 2 diabetes. Consequently, the quality of evidence will become graded as high. Open in a separate window Number 2 Heart failure hospitalization in type 2 diabetes individuals receiving SGLT2 inhibitors versus control. Effect of SGLT-2i on MACE in Individuals With Type 2 Diabetes Five RCTs evaluating SGLT-2i on MACE were recognized (8, 11, 17C19), 37,139 type 2 diabetes mellitus AN3365 individuals were randomly assigned to 21,135 receive different SGLT-2i and 16,004 receive placebo; 2,123 and 1,688 individuals incurred MACE, respectively. There was no significant heterogeneity among five studies ( 0.007) ( Figure 3 ). Besides, Subgroup analyses by different providers of SGLT-2i on MACE showed that compared with controls, only canagliflozin (RR, 0.81; 95% CI, 0.68 to 0.95; 0.01) and empagliflozin (RR, 0.86; 95% CI, 0.75 to 0.99; 0.04) significantly decreased MACE occurrence in individuals with type 2 diabetes. Because of subgroup analyses result, the quality of evidence will become graded as moderate. Open in a separate window Number 3 MACE in type 2 diabetes individuals receiving SGLT2 inhibitors versus control. Effect of SGLT-2i on Cardiovascular Death in Individuals With Type 2 Diabetes Seven RCTs evaluating SGLT-2i on cardiovascular death were recognized (8, 10, 11, 17C20), 45,621 type 2 diabetes mellitus individuals were randomly assigned to 25,377 receive SGLT-2i and 20,244 receive placebo; 1,254 and 1,227 individuals incurred cardiovascular death, respectively. There was significant heterogeneity among seven studies ( 0.05, = 0.04) ( Number 4 ). Subgroup analyses by different providers of SGLT-2i on cardiovascular death showed that compared with controls, only canagliflozin decreased cardiovascular death event but without statistical significance in individuals with type 2 diabetes (RR, 0.78; 95% CI, 0.62 to 1 1.00; = 0.05). Because of the significant heterogeneity among seven studies and subgroup analyses result, the quality of evidence will become graded as low. Open in a separate window Number 4 Cardiovascular death in type 2 diabetes individuals receiving SGLT2 inhibitors versus control. Effect of SGLT-2i on Death From Any Cause in Individuals With Type 2 Diabetes Seven RCTs evaluating SGLT-2i on death from any cause were recognized (8, 10, 11, 17C20), 45,621 type 2 diabetes mellitus individuals were randomly assigned to 25,377 receive different SGLT-2i and 20,244 receive placebo; 1,889 and 1,889 individuals.