Zenodo
Cardiovascular and Renal Benefits of Sodium–Glucose Cotransporter 2 Inhibitors in Patients Without Diabetes: A Review of Current Evidence
By C. Vasquez Hernandez, K. Martinez Sierra, A. Guerra Urquijo and 1 others.
Abstract
Background
: Sodium–glucose cotransporter 2 (SGLT2) inhibitors were initially developed to improve glycemic control in type 2 diabetes. Large cardiovascular and kidney outcome trials subsequently demonstrated benefits that extend beyond glucose lowering, including among participants without diabetes. This evidence has changed the treatment of heart failure and chronic kidney disease (CKD), but the magnitude and clinical meaning of benefit vary by disease phenotype and outcome.
Objective
To summarize the clinical evidence for cardiovascular and renal effects of SGLT2 inhibitors in adults without diabetes, emphasizing heart failure across the ejection-fraction spectrum, CKD progression, potential mechanisms, safety, and implications for practice.
Methods
: This narrative review synthesizes landmark randomized controlled trials, prespecified and post hoc analyses by glycemic status, and major clinical practice guidelines. The discussion prioritizes trials that enrolled participants without diabetes or reported treatment effects by diabetes status. This document is a narrative synthesis rather than a completed systematic review; no exhaustive database search, duplicate screening, formal risk-of-bias assessment, or PRISMA study-flow count is claimed.