{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:33:08Z","timestamp":1793118788807,"version":"4.5.0"},"reference-count":80,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Sodium-glucose cotransporter-2 inhibitors (SGLT2Is) reduce cardio-metabolic and renal outcomes in patients with type 2 diabetes (T2D) but their efficacy and safety in older or frail individuals remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Scopus, Web of Science, Cochrane CENTRA and Google Scholar and selected randomised controlled trials and observational studies comparing SGLT2Is versus placebo\/other glucose-lowering agent for people with frailty or older individuals (&amp;gt;65\u00a0years) with T2D and heart failure (HF). Extracted data on the change in HbA1c % and safety outcomes were pooled in a random-effects meta-analysis model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included data from 20 studies (22 reports; N\u2009=\u200977,083 patients). SGLT2Is did not significantly reduce HbA1c level (mean difference \u22120.13, 95%CI: \u22120.41 to 0.14). SGLT2Is were associated with a significant reduction in the risk of all-cause mortality (risk ratio (RR) 0.81, 95%CI: \u22120.69 to 0.95), cardiac death (RR 0.80, 95%CI: \u22120.94 to 0.69) and hospitalisation for heart failure (HHF) (RR 0.69, 95%CI: 0.59\u20130.81). However, SGLT2Is did not demonstrate significant effect in reducing in the risk of macrovascular events (acute coronary syndrome or cerebral vascular occlusion), renal progression\/composite renal endpoint, acute kidney injury, worsening HF, atrial fibrillation or diabetic ketoacidosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In older or frail patients with T2D and HF, SGLT2Is are consistently linked with a decrease in total mortality and the overall burden of cardiovascular (CV) events, including HHF events and cardiac death, but not protective for macrovascular death or renal events. Adverse events were more difficult to quantify but the risk of diabetic ketoacidosis or acute kidney injury was not significantly increase.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afad254","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T11:25:42Z","timestamp":1703244342000},"source":"Crossref","is-referenced-by-count":69,"title":["Sodium-glucose cotransporter-2 inhibitors (SGLT2) in frail or older people with type 2 diabetes and heart failure: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"53","author":[{"given":"Rami","family":"Aldafas","sequence":"first","affiliation":[{"name":"University of Nottingham Division of Graduate Entry Medicine and Health Sciences, , Derby, UK"},{"name":"The Saudi Electronic University Faculty of Public Health, College of Health Science, , Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7886-8262","authenticated-orcid":false,"given":"Tomas","family":"Crabtree","sequence":"additional","affiliation":[{"name":"University of Nottingham Division of Graduate Entry Medicine and Health Sciences, , Derby, UK"},{"name":"University Hospitals Derby and Burton NHS Foundation Trust Department of Endocrinology and Diabetes, , Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Alkharaiji","sequence":"additional","affiliation":[{"name":"The Saudi Electronic University Faculty of Public Health, College of Health Science, , Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yana","family":"Vinogradova","sequence":"additional","affiliation":[{"name":"University of Nottingham Division of Primary Care, , Nottingham NG2 7RD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iskandar","family":"Idris","sequence":"additional","affiliation":[{"name":"University of Nottingham Division of Graduate Entry Medicine and Health Sciences, , Derby, UK"},{"name":"University Hospitals Derby and Burton NHS Foundation Trust Department of Endocrinology and Diabetes, , Derby, UK"},{"name":"University of Nottingham MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, NIHR, Nottingham BRC, , Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"2024013005453782100_ref1","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1002\/ejhf.1170","article-title":"Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology","volume":"20","author":"Seferovi\u0107","year":"2018","journal-title":"Eur J Heart 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