Effect of Empagliflozin on Cardiovascular Mortality and Heart Failure Hospitalizations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, has demonstrated clinically meaningful benefits in patients with heart failure (HF). This systematic review and meta-analysis aimed to assess the effect of empagliflozin on cardiovascular mortality and hospitalization for heart failure (HHF) across randomized controlled trials (RCTs). A comprehensive literature search was conducted across PubMed, Embase, Scopus, and Google Scholar, identifying five eligible RCTs. Studies were included if they evaluated empagliflozin's impact on cardiovascular mortality and HHF. A meta-analysis was performed using hazard ratios (HRs) for cardiovascular death and HHF. Data were synthesized using fixed- or random-effects models based on the degree of heterogeneity. The meta-analysis included 23,344 patients, of whom 12,849 received empagliflozin. Cardiovascular mortality was significantly reduced with empagliflozin (HR 0.86; 95% CI: 0.78-0.96). For HHF, empagliflozin reduced the risk by 30% (HR 0.70; 95% CI: 0.64-0.77) across all trials. Sensitivity analysis confirmed the robustness of these results. Empagliflozin significantly reduces cardiovascular mortality and HHF, supporting its use as a cornerstone therapy in heart failure management, especially in patients at high cardiovascular risk. These findings highlight the potential of empagliflozin as a key therapeutic intervention in heart failure care.