Resumen de Investigación
Analyzed using Evidence Intelligence™

SGLT2 inhibitors reduce cardiovascular events in diabetes

Última actualización 6 de julio de 2026

Key finding

The risk of MACE was 11.5% for SGLT2i users versus 14.2% for DPP4i users (risk-difference: 2.8 percentage-points, 95% CI: 1.1–4.4%).

This study compared the real-world effectiveness of SGLT2 inhibitors and DPP4 inhibitors in patients with type 2 diabetes and cardiovascular disease, finding that SGLT2 inhibitors were associated with lower risks of major adverse cardiovascular events.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Medium-Term (3–12 mo)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study's main message and where it applies.

Study focus

This study compared the real-world effectiveness of SGLT2 inhibitors and DPP4 inhibitors in patients with type 2 diabetes and cardiovascular disease, finding that SGLT2 inhibitors were associated with lower risks of major adverse cardiovascular events.

Clinical relevance

The findings highlight the potential advantages of SGLT2 inhibitors over DPP4 inhibitors in managing patients with type 2 diabetes and cardiovascular disease. By demonstrating lower risks of serious outcomes, these results can inform treatment decisions and improve patient care, ultimately leading to better health outcomes in this vulnerable population.

Keep in mind

The study design was non-randomized, which may introduce bias. Results may not be generalizable to all populations with type 2 diabetes. Unmeasured confounders could affect the outcomes.

Published in

Referencia de la Revista

Publication details and source links for this paper.

Puriya DWY, Kathrine KS, Bochra Z, et al. Real-world effectiveness of SGLT2 inhibitors versus DPP4 inhibitors in patients with type 2 diabetes and cardiovascular disease. Cardiovascular Diabetology. 2025;24:371. doi:10.1186/s12933-025-02924-0

Efectos Principales

SGLT2 inhibitors reduced the risk of major adverse cardiovascular events by 2.8 percentage-points.

Heart failure hospitalizations were lower by 5.1 percentage-points in SGLT2 inhibitor users.

All-cause mortality was reduced by 3.1 percentage-points with SGLT2 inhibitors.

Stroke incidence showed a risk reduction of 2.4 percentage-points with SGLT2 inhibitors.

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to SGLT2 inhibitors and All-cause mortality, Composite cardiovascular events (CV death, MI, stroke, HF hospitalization), Heart failure hospitalizations, and 1 more.

Primary intervention

SGLT2 inhibitors

Primary outcomes

  • All-cause mortality
  • Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
  • Heart failure hospitalizations

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

4
Evidence pairs
4
Relationships
3
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 72

3

Related topics

4

Evidence pairs

202

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 4 evidence relationships
  • Includes primary outcome data
  • Linked to 3 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Evidencia principal

Relación de evidencia

SGLT2 Inhibitors and Cardiovascular Outcomes

Evidencia relacionada

Tema de evidencia

Cardiometabolic Risk

Seguir evidencia

Tema de evidencia

Cardiovascular Risk

Seguir evidencia

Core evidence

Study findings

The primary outcomes reported in this study.

All-cause mortality

SGLT2 inhibitors → All-cause mortality

SGLT2 inhibitors → All-cause mortality

Evidence Intelligence™
ImpactScore™
75
Positive
EvidenceScore™
Moderate
Score 69 · Based on 2 studies
ConsistencyScore™
35
mixed
Supporting studies: Based on 2 studies
Add to Evidence Tracker

Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

SGLT2 inhibitors → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

SGLT2 inhibitors → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

Evidence Intelligence™
ImpactScore™
100
Very Positive
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Heart failure hospitalizations

SGLT2 inhibitors → Heart failure hospitalizations

SGLT2 inhibitors → Heart failure hospitalizations

Evidence Intelligence™
ImpactScore™
75
Positive
EvidenceScore™
Moderate
Score 69 · Based on 2 studies
ConsistencyScore™
35
mixed
Supporting studies: Based on 2 studies
Add to Evidence Tracker

Incidence of stroke

SGLT2 inhibitors → Incidence of stroke

SGLT2 inhibitors → Incidence of stroke

Evidence Intelligence™
ImpactScore™
100
Very Positive
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

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Saved this study

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Evidence Tracker

12 tracked topics

Saved Studies

48 studies

Research Notes

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Weekly Evidence Digest

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evidence suggest

La Evidencia Sugiere

  • SGLT2 inhibitors associated with a 2.8 percentage-point lower risk of major adverse cardiovascular events.
  • 5.1 percentage-point reduction in heart failure hospitalizations with SGLT2 inhibitors.
  • 3.1 percentage-point decrease in all-cause mortality for SGLT2 inhibitor users.
who this applies

A quién se aplica

  • Adults with type 2 diabetes and cardiovascular disease.
  • Patients currently prescribed either SGLT2 or DPP4 inhibitors.
keep in mind

Tener en Cuenta

  • The study's non-randomized design limits causal inferences.
  • Findings may not apply to younger populations or those without cardiovascular disease.
  • Further research is needed to confirm these results in diverse settings.
between the lines

Entre Líneas

  • The study design was non-randomized, which may introduce bias.
  • Results may not be generalizable to all populations with type 2 diabetes.
  • Unmeasured confounders could affect the outcomes.

Save this study

Keep this study in your Evidence Tracker so you can easily find it again whenever you need it.

Today's Activity

Your Evidence Workspace

Free account

Saved this study

Your free account becomes your personal diabetes evidence workspace.

Evidence Tracker

12 tracked topics

Saved Studies

48 studies

Research Notes

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Coming Soon

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on SGLT2 Inhibitors and Cardiovascular Outcomes, SGLT2 Inhibitors and Heart failure hospitalizations.

Relaciones de evidencia relacionadas

Explore in Evidence Archive

This study contributes to the evidence on the following intervention-outcome relationships.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does SGLT2 Inhibitors improve cardiovascular outcomes?

Strong Evidence

SGLT2 Inhibitors may improve Cardiovascular Outcomes.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    All-cause mortality

    EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Mixed | 1 study

  2. 2

    Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

  3. 3

    Incidence of stroke

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 5 supporting studies with generally consistent results and a positive effect signal.

Limitations

  • Population details are unavailable.
5 supporting studiesUpdated: Jul 2026

Does SGLT2 inhibitors improve heart failure hospitalizations?

Moderate Evidence

SGLT2 inhibitors may improve Heart failure hospitalizations.

ConsistencyScore™: Results are mixed and should be interpreted cautiously.

Evidence caveat: The available evidence reports mixed findings.

Ranked evidence signals

  1. 1

    Heart failure hospitalizations

    EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Mixed | 1 study

Why this answer: This answer is cautious because the available studies report mixed findings.

Limitations

  • Only one supporting study is available.
  • Population details are unavailable.
1 supporting studyUpdated: Jul 2026
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