LBODP046 Reduction In "Cardiovascular Death Or Hospitalisation For Heart Failure" With Sglt-2is Is Dependent On Weight Reduction: A Meta-regression Analysis

AIMS: The modern management of type 2 diabetes (T2D) has shifted focus from a "glucocentric" approach to one that focuses on outcomes reduction. As a result, the aim of management is skewed toward specific molecules like sodium glucose co-transporter 2 inhibitors (SGLT-2is) and glucagon-like peptide receptor agonists (GLP1-RAs) associated with microvascular and macrovascular benefits. The aim of this meta-regression analysis is to assess whether these molecule specific results are dependent or independent of associated metabolic benefits. METHODS: A web-based search identified five citations for the analysis. The meta-analysis was conducted on a pooled population of 46,969 patients with 26,765 patients in the SGLT-2is arm and 20,204 participants in the placebo arm. A two-step approach to analysis was planned. The first step included a meta-analysis of the cardiovascular death or hospitalization due to heart failure (CV death or hHF) end point using the random effects model to identify significant heterogeneity of the effect size. If identified, the second step would involve conducting a meta-regression analysis using three moderators (HbA1c, weight, and systolic blood pressure) to identify the co-variate explaining this heterogeneity. RESULTS: The pooled effect size of the CV death or hHF endpoint was associated with significant heterogeneity (Q: 8. 06, df: 4, I2: 50.44, p=0. 09). The model using HbA1c difference (p=0.17) between the two groups or difference in SBP (p=0.86) did not explain the variance in the observed effect size. However, the difference in weight between the SGLT-2is and placebo group correlated significantly with the variance in CV death or hHF effect size (95% CI 0. 05-0.32, p=<0. 01). The relationship between weight differential and CV death of hHF reduction is given by the formula, Y=-0.5441+0.1883*Weight difference. CONCLUSION: The reduction in CV death or hHF with SGLT-2is is not an exclusive molecule-specific effect but dependent on weight reduction. Presentation: No date and time listed