E-ISSN 1658-7820
 

Review Article
Online Published: 12 Jan 2026
 


A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction

Safi Abdullah Albeladi, Turki Dhaifallah Albeladi, Mohammed Fahad Albariqi, Sulaiman Shakir Alkayal, Abdullah Hasan Mahallawi, Batool Fawaz Albeladi, Sultanah Ammar Naitah, Manar Mohammed Almohamadi, Yasser Redha Albeladi.


Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are cornerstone therapy in heart failure (HF), but their relative effectiveness across the ejection fraction (EF) spectrum is uncertain. This was a systematic review after the PRISMA 2020 guidelines were applied to guide the assessment. From database inception to 2025, in-depth searches was conducted through PubMed/MEDLINE and Web of Science, Cochrane CENTRAL, and Google Scholar. Randomized controlled trials (RCTs) and comparative observational studies assessing the efficacy and safety of SGLT2 inhibitors in HF with reduced or preserved EF were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool for RCTs and ROBINS-I for non-randomized studies. Of 1,306 identified records, 15 studies met the inclusion criteria, encompassing over 1.5 million participants. Across trials and real-world cohorts, SGLT2 inhibitors significantly reduced heart failure hospitalizations by 20–30% and cardiovascular death by up to 25%, with benefits observed regardless of diabetes status or EF category. Empagliflozin and dapagliflozin consistently improved composite cardiovascular outcomes, renal function, and quality of life, while adverse events were mild and infrequent. Empagliflozin showed slightly greater effects on ventricular remodeling than dapagliflozin. Most RCTs demonstrated moderate quality with unclear blinding risk; non-randomized studies showed variable but generally low to moderate bias. SGLT2 inhibitors provided consistent cardio-renal benefits and reduced hospitalization and mortality risks across the HF spectrum. Their favorable safety profile supports early integration into guideline-directed therapy for both HFrEF and HFpEF patients.

Key words: SGLT2 inhibitors, heart failure, ejection fraction, cardiovascular outcomes, PRISMA.


 
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How to Cite this Article
Pubmed Style

Albeladi SA, Albeladi TD, Albariqi MF, Alkayal SS, Mahallawi AH, Albeladi BF, Naitah SA, Almohamadi MM, Albeladi YR. A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction. IJMDC. 2026; 10(1): 341-350. doi:10.24911/IJMDC.51-1764168665


Web Style

Albeladi SA, Albeladi TD, Albariqi MF, Alkayal SS, Mahallawi AH, Albeladi BF, Naitah SA, Almohamadi MM, Albeladi YR. A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction. https://www.ijmdc.com/?mno=299610 [Access: January 25, 2026]. doi:10.24911/IJMDC.51-1764168665


AMA (American Medical Association) Style

Albeladi SA, Albeladi TD, Albariqi MF, Alkayal SS, Mahallawi AH, Albeladi BF, Naitah SA, Almohamadi MM, Albeladi YR. A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction. IJMDC. 2026; 10(1): 341-350. doi:10.24911/IJMDC.51-1764168665



Vancouver/ICMJE Style

Albeladi SA, Albeladi TD, Albariqi MF, Alkayal SS, Mahallawi AH, Albeladi BF, Naitah SA, Almohamadi MM, Albeladi YR. A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction. IJMDC. (2026), [cited January 25, 2026]; 10(1): 341-350. doi:10.24911/IJMDC.51-1764168665



Harvard Style

Albeladi, S. A., Albeladi, . T. D., Albariqi, . M. F., Alkayal, . S. S., Mahallawi, . A. H., Albeladi, . B. F., Naitah, . S. A., Almohamadi, . M. M. & Albeladi, . Y. R. (2026) A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction. IJMDC, 10 (1), 341-350. doi:10.24911/IJMDC.51-1764168665



Turabian Style

Albeladi, Safi Abdullah, Turki Dhaifallah Albeladi, Mohammed Fahad Albariqi, Sulaiman Shakir Alkayal, Abdullah Hasan Mahallawi, Batool Fawaz Albeladi, Sultanah Ammar Naitah, Manar Mohammed Almohamadi, and Yasser Redha Albeladi. 2026. A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction. International Journal of Medicine in Developing Countries, 10 (1), 341-350. doi:10.24911/IJMDC.51-1764168665



Chicago Style

Albeladi, Safi Abdullah, Turki Dhaifallah Albeladi, Mohammed Fahad Albariqi, Sulaiman Shakir Alkayal, Abdullah Hasan Mahallawi, Batool Fawaz Albeladi, Sultanah Ammar Naitah, Manar Mohammed Almohamadi, and Yasser Redha Albeladi. "A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction." International Journal of Medicine in Developing Countries 10 (2026), 341-350. doi:10.24911/IJMDC.51-1764168665



MLA (The Modern Language Association) Style

Albeladi, Safi Abdullah, Turki Dhaifallah Albeladi, Mohammed Fahad Albariqi, Sulaiman Shakir Alkayal, Abdullah Hasan Mahallawi, Batool Fawaz Albeladi, Sultanah Ammar Naitah, Manar Mohammed Almohamadi, and Yasser Redha Albeladi. "A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction." International Journal of Medicine in Developing Countries 10.1 (2026), 341-350. Print. doi:10.24911/IJMDC.51-1764168665



APA (American Psychological Association) Style

Albeladi, S. A., Albeladi, . T. D., Albariqi, . M. F., Alkayal, . S. S., Mahallawi, . A. H., Albeladi, . B. F., Naitah, . S. A., Almohamadi, . M. M. & Albeladi, . Y. R. (2026) A systematic review on the efficacy of SGLT2 inhibitors in heart failure with reduced and preserved ejection fraction. International Journal of Medicine in Developing Countries, 10 (1), 341-350. doi:10.24911/IJMDC.51-1764168665





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