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Table 2 GRADE evidence profile

From: Effect of sodium–glucose cotransporter 2 inhibitors on cardiac structure and function in type 2 diabetes mellitus patients with or without chronic heart failure: a meta-analysis

Certainty assessment No. of patients Effect Certainty Importance
No. of studies Study design Risk of bias Inconsistency Indirectness Imprecision Other considerations SGLT2i Control Relative (95% CI) Absolute (95% CI)
LVMI
 6 Randomized trials Not serious Not serious Not serious Seriousa None 251 254 – MD 0.96 lower (2.69 lower to 0.77 higher) ⨁⨁⨁◯
Moderate 		Important
LVEDVI
 3 Randomized trials Not serious Not serious Not serious Seriousa None 89 93 – MD 1.32 higher (2.20 lower to 4.85 higher) ⨁⨁⨁◯
Moderate 		Important
LVESVI
 3 Randomized trials Not serious Not serious Not serious Seriousa None 89 93 – MD 0.03 lower (3.08 lower to 3.02 higher) ⨁⨁⨁◯
Moderate 		Important
LAVI
 4 Randomized trials Not serious Not serious Not serious Seriousa None 187 182 – MD 0.28 lower (1.98 lower to 1.42 higher) ⨁⨁⨁◯
Moderate 		Important
LVEF
 9 Randomized trials Not serious Not serious Not serious Seriousa None 427 442 - MD 0.21 higher (0.65 lower to 1.06 higher) ⨁⨁⨁◯
Moderate 		Important
LVEF in HFrEF
 2 Randomized trials Serious b Not serious Not serious Seriousa None 70 74 – MD 3.16 higher (0.11 higher to 6.22 higher) ⨁⨁◯◯
Low 		Important
LVEF in HFpEF
 2 Randomized trials Not serious Not serious Not serious Seriousa None 151 158 – MD 0.19 higher (1.76 lower to 2.15 higher) ⨁⨁⨁◯
Moderate 		Important
GLS
 4 Randomized trials Not serious Not serious Not serious Seriousa None 162 164 – MD 0.38 lower (1.04 lower to 0.29 higher) ⨁⨁⨁◯
Moderate 		Important
E/eʹ
 8 Randomized trials Not serious Not serious Not serious Seriousa None 354 371 – MD 0.45 lower (0.88 lower to 0.03 lower) ⨁⨁⨁◯
Moderate 		Important
NT-proBNP
 11 Randomized trials Not serious Not serious Not serious Seriousa None 1997 1777 – SMD 0.09 lower (0.16 lower to 0.03 lower) ⨁⨁⨁◯
Moderate 		Critical
NT-proBNP (ln scale)
 3 Randomized trials Not serious Not serious Not serious Seriousa None 2702 1629 – SMD 0.12 lower (0.17 lower to 0.07 lower) ⨁⨁⨁◯
Moderate 		Critical
KCCQ
 3 Randomized trials Not serious Not serious Not serious Not serious None 2610 2607 – SMD 3.12 higher (0.76 higher to 5.47 higher) ⨁⨁⨁⨁
High 		Critical
  1. SGLT2i sodium–glucose cotransporter 2 inhibitors, MD mean difference, SMD standardized mean difference, HFrEF heart failure with reduced ejection fraction, HFpEF heart failure with preserved ejection fraction, LVMI left ventricular mass indexed by body surface area, LVEDVI left ventricular end diastolic volume indexed by body surface area, LVESVI left ventricular end systolic volume indexed by body surface area, LAVI left atrial volume indexed by body surface area, LVEF left ventricular ejection fraction, GLS global longitudinal strain, E/e' mitral inflow to mitral relaxation velocity ratio, NT-proBNP N-terminal pro-brain natriuretic peptide, KCCQ the Kansas City Cardiomyopathy Questionnaire
  2. aSample size below optimal information size contributing to imprecision which lowers our certainty in effect
  3. bOne in the two studies is of high risk according to the Cochrane risk of bias tool. And excluding the study would cause change of the results
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Cardiovascular Diabetology

ISSN: 1475-2840