Summary

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• This summary is based on the review of 73 systematic review(s)/meta-analysis(es). ^[1-74]
• Heart Failure with Preserved Ejection Fraction (HFpEF): Sodium-glucose cotransporter-2 (SGLT2) inhibitors, including empagliflozin, significantly reduced cardiovascular hospitalizations in HFpEF patients across different baseline characteristics, though they did not reduce cardiovascular mortality.
• Type 2 Diabetes Mellitus (T2DM) and Cardiovascular Outcomes: In patients with T2DM, SGLT2 inhibitors, particularly empagliflozin, decreased heart failure-related hospitalizations and showed potential in improving broader cardiovascular outcomes.
• Heart Failure with Reduced Ejection Fraction (HFrEF): Empagliflozin notably reduced cardiovascular death and heart failure hospitalizations in HFrEF patients, with benefits observed in specific subgroups, including elderly, diabetic, ischemic, female patients, and those on sacubitril/valsartan.
• Acute Coronary Syndrome (ACS): Empagliflozin improved cardiac parameters such as left ventricular end-systolic volume index and left ventricular mass index in ACS patients, though it did not significantly impact left ventricular ejection fraction.
• General Safety Profile: Empagliflozin and other SGLT2 inhibitors displayed a safety profile comparable to placebo, with no increased risk of severe adverse events such as hypoglycemia, bone fractures, or lower limb amputations, although a slight increase in ketoacidosis and serious volume depletion was observed.
• Acute Kidney Injury (AKI): SGLT2 inhibitors, including empagliflozin, significantly reduced the risk of AKI, especially in patients with heart failure with reduced ejection fraction, supporting renal safety in this population.
• Gender-Specific Adverse Effects: Women taking empagliflozin showed a higher incidence of serious urinary tract infections and pyelonephritis compared to men, indicating a need for monitoring in this subgroup.
• Increased Risk of Genital Infections: SGLT2 inhibitors were associated with a higher risk of genital infections, particularly empagliflozin and dapagliflozin, emphasizing the importance of vigilance for these adverse events during treatment.
• Empagliflozin demonstrated a significant reduction in cardiovascular death and heart failure hospitalizations across specific subgroups, including elderly patients (>65 years), patients with chronic kidney disease, diabetic patients, and heart failure patients with both reduced and preserved ejection fractions.
• In gender-specific findings, empagliflozin was associated with an increased incidence of serious urinary tract infections in women, while it was well tolerated in pediatric patients with diabetes and glycogen storage diseases, with hypoglycemia being the most common mild adverse effect.