AIMS Sodium-glucose cotransporter-2 inhibitors (gliflozins) and statins are oral drugs that may have beneficial cardiovascular effects in patients with type 2 diabetes, especially in those with known cardiovascular disease. We planned a systematic review and meta-analysis of cardiovascular outcome trials (CVOTs) that evaluated the effect of gliflozins on MACE risk in patients with T2D stratified by age and by statin use. METHODS The electronic search was carried out until 20 January 2020. RCTs were included if they were CVOTs performed in adults with T2D, compared add-on therapy with any gliflozin versus placebo, and had major cardiovascular events (MACE) as primary outcome. We limited the evaluation to MACE in order to minimize the statistical impact of post-hoc analyses. We used a random-effect model to calculate hazard ratio (HR) and 95% CI. RESULTS The hazard ratio for MACE was 0.95 (95% CI, 0.86-1.05) in people <65 years and 0.83 (95% CI, 0.71-0.96) for people ≥65 years, with no subgroup differences (P-value = 0.15), suggesting that the effect was consistent across age categories. The hazard ratio for MACE was 0.87 (95% CI, 0.81-0.94) in people taking a statin and 0.88 (95% CI, 0.77-1.01) for people not taking statin, with no subgroup differences (P-value = 0.90). CONCLUSIONS The results are reassuring, as they confirm that the efficacy profile of gliflozins is unchanged by age, and may further enhance the CV protection offered by statin.

中文翻译：

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SGLT-2抑制剂在老年糖尿病患者中的功效：系统评价与心血管结局试验的荟萃分析。

AIMS钠葡萄糖共转运蛋白2抑制剂（gliflozins）和他汀类药物是口服药物，可能对2型糖尿病患者，尤其是已知心血管疾病的患者具有有益的心血管作用。我们计划对心血管结果试验（CVOT）进行系统的回顾和荟萃分析，评估按年龄和他汀类药物分层使用的格列净对T2D患者MACE风险的影响。方法进行电子搜索直至2020年1月20日。如果RCT是成年人T2D的CVOT，将格列净与安慰剂进行了联合治疗进行比较且以主要心血管事件（MACE）为主要结果，则将其包括在内。为了将事后分析的统计影响最小化，我们将评估限制为MACE。我们使用随机效应模型计算危险比（HR）和95％CI。结果在65岁以下人群中，MACE的危险比为0.95（95％CI，0.86-1.05），在65岁以上人群中为0.83（95％CI，0.71-0.96），无亚组差异（P值= 0.15） ，表明该效果在各个年龄段均一致。服用他汀类药物的人的MACE危险比为0.87（95％CI，0.81-0.94），不服用他汀类药物的人为0.88（95％CI，0.77-1.01），无亚组差异（P值= 0.90）。结论结果令人放心，因为它们证实了格列净的疗效随年龄而变化，并且可能进一步增强他汀类药物的心血管保护作用。这表明该效果在各个年龄段均一致。服用他汀类药物的人的MACE危险比为0.87（95％CI，0.81-0.94），不服用他汀类药物的人为0.88（95％CI，0.77-1.01），无亚组差异（P值= 0.90）。结论结果令人放心，因为它们证实了格列净的疗效随年龄而变化，并且可能进一步增强他汀类药物的心血管保护作用。这表明该效果在各个年龄段均一致。服用他汀类药物的人的MACE危险比为0.87（95％CI，0.81-0.94），不服用他汀类药物的人为0.88（95％CI，0.77-1.01），无亚组差异（P值= 0.90）。结论结果令人放心，因为它们证实了格列净的疗效随年龄而变化，并且可能进一步增强他汀类药物的心血管保护作用。