Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve cardiovascular outcomes in patients with heart failure (HF). However, studies examining their benefits exclusively in nondiabetic patients on various HF outcomes are limited. By conducting a MEDLINE and ClinicalTrials.gov search for randomized controlled trials, we identified four studies on SGLT2i with data on HF outcomes in nondiabetic patients and performed a meta-analysis. 5316 patients in the SGLT2i group and 5322 in the placebo group were included in this meta-analysis. The composite of worsening HF (hospitalization for HF, urgent visit for HF) or cardiovascular death had 726 events (13.66%) in the SGLT2i group and 907 (17.04%) in the placebo group, with a hazard ratio (HR) of 0.78, 95% confidence interval (CI) of 0.71 to 0.86 (p<0.0001). There were 551 events (10.36%) of hospitalization for HF in the SGLT2i group, compared to 751 (14.11%) in the placebo group with an HR of 0.71, 95% CI of 0.62 to 0.81 (p<0.0001). Cardiovascular death occurred in 396 patients (7.45%) in the SGLT2i group, 452 (8.49%) in the placebo group, with an HR of 0.88, 95% CI of 0.77 to 1.00 (p=0.059). All-cause mortality occurred in 552 patients (10.38%) in the SGLT2i group and 586 (11.01%) in the placebo group with an HR of 0.95 and a 95% CI of 0.84 to 1.07 (p=0.37). This study showed that in patients with HF without diabetes mellitus, SGLT2i improve HF outcomes, including a significant decrease in hospitalizations for HF and a favorable response for the outcome of cardiovascular death.

中文翻译：

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SGLT2 抑制剂对非糖尿病患者心力衰竭结果的作用：随机对照试验的系统回顾和荟萃分析。

钠-葡萄糖协同转运蛋白 2 抑制剂 (SGLT2i) 可改善心力衰竭 (HF) 患者的心血管结局。然而，专门检验其对非糖尿病患者对各种心力衰竭结局的益处的研究有限。通过 MEDLINE 和 ClinicalTrials.gov 搜索随机对照试验，我们确定了四项关于 SGLT2i 的研究以及非糖尿病患者心力衰竭结果的数据，并进行了荟萃分析。本次荟萃分析纳入了 SGLT2i 组的 5316 名患者和安慰剂组的 5322 名患者。SGLT2i 组中心力衰竭恶化（心力衰竭住院、心力衰竭紧急就诊）或心血管死亡的复合事件有 726 起（13.66%），安慰剂组有 907 起（17.04%），风险比（HR）为 0.78， 95% 置信区间 (CI) 为 0.71 至 0.86 (p<0.0001)。SGLT2i 组有 551 例 (10.36%) 因心衰住院事件，而安慰剂组有 751 例 (14.11%)，HR 为 0.71，95% CI 为 0.62 至 0.81 (p<0.0001)。SGLT2i 组有 396 名患者（7.45%）发生心血管死亡，安慰剂组有 452 名患者（8.49%）发生心血管死亡，HR 为 0.88，95% CI 为 0.77 至 1.00（p=0.059）。SGLT2i 组有 552 名患者（10.38%）发生全因死亡，安慰剂组有 586 名患者（11.01%）发生全因死亡，HR 为 0.95，95% CI 为 0.84 至 1.07（p=0.37）。这项研究表明，在没有糖尿病的心力衰竭患者中，SGLT2i 可以改善心力衰竭的结局，包括显着减少因心力衰竭住院的人数以及对心血管死亡结局的良好反应。