Understanding The Role of SGLT2 Inhibitors in Cardiovascular Risk Reduction for Type 2 Diabetes Patients-A Literature Review
Authors:   Physician, Universidad Técnica de Manabí, Master’s Degree in Health Direction and Management, Specialist in Occupational Safety and Health at Pontificia Universidad Católica of Ecuador, ORCID: 0009-0005-1616-2949., Molina Jorge Eduardo Arteaga , Valdez Ney Asdrubal Macias ,   Physician, Universidad Laica Eloy Alfaro de Manabí, ORCID: 0000-0003-3191-2937, Corredor Diego Alberto Vargas ,   Medicine, Universidad Estatal de Guayaquil, ORCID: 0009-0009-9976-680X, Cruzatty José Manuel Vera ,   Physician, Universidad Laica Eloy Alfaro de Manabí, ORCID: 0009-0000-6366-7820, Alfonso Annabel Fernández ,   Physician, Specialist in Intensive Care and Emergency, Universidad de Ciencias Médicas de la Habana, Cuba, ORCID: 0009-0009-6254-8120, Luzardo Boris Alexander Zapata ,   Physician, Universidad de Guayaquil, ORCID: 0009-0002-4483-3816, Coronel Mite Ana Paula ,   Physician, Universidad Católica Santiago de Guayaquil, ORCID: 0009-0005-2435-5492, Muñoz Calle Viviana Eloisa ,   Physician, Independent Investigator, ORCID: 0000-0002-5026-0121
Published: March 2024

Introduction: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular events and heart failure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as a novel class of antidiabetic agents with potential cardiovascular benefits. This systematic review aims to evaluate the impact of SGLT2 inhibitors on reducing cardiovascular events and heart failure hospitalizations in patients with T2DM. Aims: The review aims to comprehensively evaluate the impact of SGLT2 inhibitors on reducing cardiovascular events, including MACE, and HF hospitalizations in patients with T2DM. Methods: A comprehensive literature search was conducted in major electronic databases like PubMed, Google Scholar and Science Direct to identify relevant studies. Studies investigating the cardiovascular outcomes of SGLT2 inhibitors in T2DM patients were included. Data extraction and quality assessment were performed independently by three reviewers using predefined criteria. Results: A total of 17 studies met the inclusion criteria and were included in the review. The analysis of clinical trials, including EMPA-REG OUTCOME, CANVAS Program, and DECLARE-TIMI 58, demonstrated significant reductions in MACE and HF hospitalizations with SGLT2 inhibitors compared to placebo or standard care. Real-world evidence from studies such as the CVD-REAL and EASEL studies further supported these findings, showing consistent cardiovascular benefits of SGLT2 inhibitors in routine clinical practice. The findings suggest that SGLT2 inhibitors are associated with a reduction in cardiovascular events, including myocardial infarction, stroke, and cardiovascular mortality, as well as a decreased risk of heart failure hospitalizations in patients with T2DM. Conclusion: This systematic review provides evidence supporting the cardiovascular benefits of SGLT2 inhibitors in T2DM management. The findings underscore the importance of considering these agents as part of comprehensive cardiovascular risk reduction strategies in T2DM patients. Further research is necessary to explicate the mechanisms underlying these benefits and optimize their clinical use.