CONGRESS ABSTRACT

Introduction: Recent studies have indicated that sodium-glucose cotransporter-2 inhibitors (SGLT2i) may possess cardioprotective properties, providing dual benefits for patients in cardio-oncology. However, their specific effects on reducing the risk of hospitalization for heart failure (HF) in patients with type 2 diabetes mellitus (T2DM) undergoing anticancer treatments remain to be fully explored. Aim: This study aims to assess the cardioprotective effects of SGLT2i in reducing hospitalizations for HF in T2DM patients receiving chemotherapy. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search of Medline, Embase, and Scopus to identify all observational studies published up to June 2024. These studies needed to have at least one year of follow-up and analysed the risk of HF hospitalization in T2DM patients undergoing chemotherapy. The risk of HF hospitalization was evaluated using the Mantel-Haenszel random effects model, with odds ratios (OR) as the effect measure and 95% confidence intervals (CIs). A predefined sensitivity analysis (leave-one-out analysis) was performed by removing one study at a time to assess the stability of the results. Heterogeneity was evaluated using the Higgins I² statistic. Results:  Five studies involving 7,213 T2DM patients undergoing chemotherapy were analysed, with 2,428 in the SGLT2i group and 4,785 in the non-SGLT2i group. Patients treated with SGLT2i exhibited a significantly lower risk of HF hospitalization (OR: 0.46; 95% CI: 0.35-0.60; I² = 0). Sensitivity analysis confirmed yielded results, reporting ORs ranging from 0.41 (95% CI: 0.30–0.74; I²: 0%) to 0.53 (95% CI: 0.50–0.77; I²: 0%), indicating that the results were not influenced by any single study. Conclusions: SGLT2 inhibitors appear to provide cardioprotective effects concerning HF hospitalization in T2DM patients undergoing chemotherapy. These findings suggest that SGLT2i may play a significant role in managing cardiovascular risks in this vulnerable population.