Efficacy Comparison of Sodium-Glucose Cotransporter-2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, and Dipeptidyl Peptidase-4 Inhibitors in Heart Failure with Preserved Ejection Fraction: A Systematic Review And Network Meta-Analysis

Background: Heart failure with preserved ejection fraction (HFpEF) represents a major unmet therapeutic need with limited evidence-based pharmacologic options. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated benefit, while the roles of glucagon-like peptide-1 receptor agonists (GLP-1 RA) and dipeptidyl peptidase-4 inhibitors (DPP-4i) remain less clear. A direct and indirect comparison of these antihyperglycemic drug classes on cardiovascular outcomes in HFpEF is required. Me