SGLT2 Inhibitors and Heart Failure

Abstract

To determine whether SGLT2 inhibitors reduce hospital admissions and death, we analyzed 9 randomized controlled trials including 71,553 patients with heart failure or increased cardiovascular risk, identified from MEDLINE and Cochrane CENTRAL in January 2026.
We combined results from these studies using a method that accounts for differences between them.
We analyzed the data in a standard way and applied a method to make confidence intervals more reliable.
SGLT2 inhibitors reduced the combined outcome of heart failure hospitalization and cardiovascular death by 23 percent.
Importantly, the benefit was similar in patients with both reduced and preserved ejection fraction, showing effectiveness across the full spectrum of heart function.
The results were consistent, as they remained unchanged when individual studies were removed, when potential bias was adjusted, and when only specific trial types were analyzed.
Overall, these drugs significantly reduce heart failure events regardless of ejection fraction, but differences between individual drugs remain uncertain.