{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:11:07Z","timestamp":1793833867237,"version":"4.6.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,8,15]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Sodium\u2010glucose cotransporter\u20102 (SGLT2) inhibitors reduce atherosclerotic cardiovascular disease (ASCVD) events in patients with prior ASCVD and type 2 diabetes; however, this benefit is uncertain in patients without established ASCVD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Large\u2010scale cardiovascular outcome randomized controlled trials or their prespecified subgroup analyses were selected, evaluating SGLT2 inhibitors versus placebo for primary prevention of ASCVD (inception, March 2023). The primary outcome was atherosclerotic major adverse cardiovascular events (MACEs), which was a composite of cardiovascular mortality, myocardial infarction, and stroke. The secondary outcomes were individual components of MACEs and all\u2010cause mortality. The outcomes were reported as random\u2010effect relative risk (RR) with a 95% CI. This analysis, comprising 23\u2009987 patients enrolled in 5 randomized controlled trials with a mean follow\u2010up duration of \u2248135\u2009weeks, found no significant reduction in atherosclerotic MACEs with SGLT2 inhibitors in comparison to placebo (RR, 0.85 [95% CI, 0.71\u20131.01];\n              <jats:italic>P<\/jats:italic>\n              =0.07; I\n              <jats:sup>2<\/jats:sup>\n              =44). There were no significant differences in cardiovascular mortality (RR, 0.93 [95% CI, 0.77\u20131.14];\n              <jats:italic>P<\/jats:italic>\n              =0.50; I\n              <jats:sup>2<\/jats:sup>\n              =0), myocardial infarction (RR, 0.88 [95% CI, 0.69\u20131.11];\n              <jats:italic>P<\/jats:italic>\n              =0.28; I\n              <jats:sup>2<\/jats:sup>\n              =23), and stroke (RR, 0.84 [95% CI, 0.62\u20131.16];\n              <jats:italic>P<\/jats:italic>\n              =0.29; I\n              <jats:sup>2<\/jats:sup>\n              =46). SGLT2 inhibitors significantly improved all\u2010cause mortality (RR, 0.85 [95% CI, 0.72\u20131.0];\n              <jats:italic>P<\/jats:italic>\n              =0.04; I\n              <jats:sup>2<\/jats:sup>\n              =23). On subgroup analyses, the use of SGLT2 inhibitors led to significant reductions in MACEs (RR, 0.74 [95% CI, 0.61\u20130.89];\n              <jats:italic>P<\/jats:italic>\n              =0.001), myocardial infarction (RR, 0.67 [95% CI, 0.47\u20130.97];\n              <jats:italic>P<\/jats:italic>\n              =0.03), and stroke (RR, 0.61 [95% CI, 0.41\u20130.91];\n              <jats:italic>P<\/jats:italic>\n              =0.01) primarily in patients with chronic kidney disease along with type 2 diabetes, whereas these benefits were not observed in patients with type 2 diabetes without chronic kidney disease.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">SGLT2 inhibitors significantly reduced atherosclerotic MACEs in subjects having both chronic kidney disease and type 2 diabetes without established ASCVD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030578","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T10:35:40Z","timestamp":1691663740000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Sodium\u2010Glucose Cotransporter\u20102 Inhibitors and Primary Prevention of Atherosclerotic Cardiovascular Disease: A Meta\u2010Analysis of Randomized Trials and Systematic Review"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8834-9105","authenticated-orcid":false,"given":"Hammad","family":"Rahman","sequence":"first","affiliation":[{"name":"Division of Cardiology Guthrie Robert Packer Hospital Sayre PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1559-6911","authenticated-orcid":false,"given":"Safi U.","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Methodist Hospital Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad N.","family":"Lone","sequence":"additional","affiliation":[{"name":"Division of Cardiology Guthrie Robert Packer Hospital Sayre PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Division of Cardiology Guthrie Robert Packer Hospital Sayre PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahathi","family":"Kunduru","sequence":"additional","affiliation":[{"name":"Department of Medicine Guthrie Robert Packer Hospital Sayre PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5579-2074","authenticated-orcid":false,"given":"Saurabh","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Cardiology Guthrie Health System\/Robert Packer Hospital Sayre PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhakar","family":"Sattur","sequence":"additional","affiliation":[{"name":"Division of Cardiology Guthrie Health System\/Robert Packer Hospital Sayre PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1400-3988","authenticated-orcid":false,"given":"Edo","family":"Kaluski","sequence":"additional","affiliation":[{"name":"Division of Cardiology Guthrie Health System\/Robert Packer Hospital Sayre PA"},{"name":"Division of Cardiology Rutgers New Jersey Medical School Newark NJ"},{"name":"Division of Cardiology The Geisinger Commonwealth Medical College Scranton PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02074-8"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001062"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32590-X"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014908"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.4511"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1600827"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.042007"},{"key":"e_1_3_1_9_2","unstructured":"Bhatt DL Szarek M Pitt B Steg PG. 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