Meta-analysis shows SGLT2 inhibitors reduce all-cause mortality in heart failure patients

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Frontiers in Medicine Published May 13, 2026 Medically reviewed May 13, 2026 DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Meta-analysis suggests SGLT2 inhibitors reduce all-cause mortality in heart failure patients.

This meta-analysis examined the effects of SGLT2 inhibitor therapy in a population of patients with heart failure, irrespective of ejection fraction or diabetes status. The study encompassed 28,484 participants and evaluated several outcomes including all-cause mortality, heart failure hospitalization, NT-proBNP levels, left ventricular systolic function, and diuretic efficiency. The comparator was not reported in the source data.

The primary outcome of all-cause mortality showed a 14% reduction associated with the intervention. The effect size was a hazard ratio of 0.86 with a 95% confidence interval of 0.79 to 0.92. Secondary outcomes included heart failure hospitalization, NT-proBNP levels, left ventricular systolic function, and diuretic efficiency, though specific pooled estimates for these were not detailed in the provided text.

Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported in the source. The authors did not list specific limitations beyond the absence of reported safety data. Practice relevance is suggested by the mortality benefit, but clinicians should note the lack of detailed safety information when considering these agents for heart failure management.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundHeart failure (HF) remains a major global health challenge, with high rates of hospitalization and mortality despite advances in therapy. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, originally developed as antidiabetic agents, have demonstrated significant cardiovascular and renal benefits across a wide range of patients.ObjectiveThis study aims to evaluate the impact of SGLT2 inhibitors on all-cause mortality, heart failure hospitalization, and secondary outcomes, including NT-proBNP levels, left ventricular (LV) systolic function, and diuretic efficiency in patients with heart failure, irrespective of ejection fraction or diabetes status.MethodsA systematic review and a meta-analysis were conducted according to PRISMA 2020 guidelines. Electronic databases (PubMed, Embase, Cochrane CENTRAL, Scopus, and Web of Science) were searched for randomized controlled trials (RCTs) published between January 2017 and November 2025. A total of 15 eligible RCTs encompassing 28,484 participants were included. Data were extracted on clinical and functional outcomes, and pooled estimates were calculated using a DerSimonian–Laird random-effects model. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using Egger’s and Begg’s tests.ResultsSGLT2 inhibitor therapy was associated with a 14% reduction in all-cause mortality (HR = 0.86, 95% CI: 0.79–0.92; p