Table 2.
GRADE evidence profile
| 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 |
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
aSample size below optimal information size contributing to imprecision which lowers our certainty in effect
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