Researchers pooled data from 32 randomized controlled trials involving over 140,000 patients to compare how SGLT2 inhibitors and GLP-1 receptor agonists affect heart rhythm and cardiovascular outcomes in people with type 2 diabetes or heart failure. SGLT2 inhibitors — including dapagliflozin and empagliflozin — consistently reduced hospitalizations for heart failure. Empagliflozin also showed a statistically significant but exploratory signal for lower ventricular arrhythmia risk in diabetic patients. Dapagliflozin and empagliflozin reduced cardiovascular and all-cause mortality in relevant subgroups. Most drugs did not increase arrhythmia risk. Safety signals around diabetic ketoacidosis and fractures require cautious interpretation due to inconsistent adverse-event reporting across trials.
