Heterogeneity in cardiorenal protection by Sodium glucose cotransporter 2 inhibitors in heart failure across the ejection fraction strata: Systematic review and meta-analysis

Figure 1 PRISMA flow diagram.

Figure 2 Meta-analysis of primary composite outcome. A: Gliflozins’ effect on the primary composite outcome across heart failure subtypes; B: Gliflozins’ effect on the composite outcome of ‘cardiovascular deaths or hospitalizations due to heart failure or urgent visits’ across heart failure subtypes. HF: Heart failure; HFpEF: Heart failure with preserved ejection fraction; HFrEF: Heart failure with reduced ejection fraction; nos: Not otherwise specified; N/A: Not available. ^aper 1000 person-years; ^bper 100 person-years.

Figure 3 Meta-analysis of the effects of Sodium glucose cotransporter 2 inhibitors on the all-cause mortality across the heart failure subtypes. HF: Heart failure; HFpEF: Heart failure with preserved ejection fraction; HFrEF: Heart failure with reduced ejection fraction; nos: Not otherwise specified. ^aper 1000 person-years.

Figure 4 Meta-analysis of the effects of Sodium glucose cotransporter 2 inhibitors on the primary composite outcome of heart failure patients across different New York Heart Associations classifications. ^aper 1000 person-years.

Figure 5 Meta-analysis of Sodium glucose cotransporter 2 inhibitors’ effect on ‘cardiovascular death or heart failure hospitalizations or urgent visits’ across the patients’ baseline left ventricular ejection fraction strata. A: Left ventricular ejection fraction (LVEF) < 30% vs ≥ 30%; B: LVEF < 40% vs ≥ 40%; C: LVEF < 45% vs LVEF ≥ 45%; D: LVEF < 50% vs LVEF ≥ 50%; E: LVEF < 60% vs LVEF ≥ 60%. ^aper 1000 person-years; ^bper 100 person-years; ^canalysis based on the “history of previous LVEF < 40%” reported by DELIVER trial; LVEF: Left ventricular ejection fraction; N/A: Not available.

Figure 6 Meta-analysis of gliflozins’ effect on the all-cause mortality across left ventricular ejection fraction strata (versus placebo). A: Left ventricular ejection fraction (LVEF) ≤ 30% vs > 30%; B: LVEF ≤ 40% vs > 40%; C: LVEF ≤ 45% vs LVEF > 45%; D: LVEF ≤ 50% vs LVEF > 50%; E: LVEF ≤ 60% vs LVEF > 60%. ^bper 100 person-years. LVEF: Left ventricular ejection fraction; N/A: Not available.

Figure 7 Meta-analysis of the Sodium glucose cotransporter 2 inhibitors’ effect on different renal outcome indices across heart failure subtypes. A: Composite renaloutcome; B: Acute kidney injury. HF: Heart failure; HFpEF: Heart failure with preserved ejection fraction; HFrEF: Heart failure with reduced ejection fraction; nos: Not otherwise specified.