Fig.1 Comparison of hazard ratios (HR) for key events across four cardiovascular outcomes trials of SGLT2 inhibitors The forest plot displays hazard ratios (HR) with 95% confidence intervals for 3-point MACE (cardiovascular death, non-fatal myocardial infarction, or stroke), cardiovascular death (CV death), and heart failure hospitalization (HF hospitalization) in the EMPA-REG OUTCOME, CANVAS Program, DECLARE-TIMI 58, and VERTIS CV trials. The vertical dashed line at HR=1.0 represents the null effect, with HR values to the left (<1.0) indicating statistically significant risk reduction. The x-axis scale (0.0-1.0) demonstrates the magnitude of cardiovascular risk reduction observed across trials. Data were extracted from references [8-11].

Fig.2 Comparison of hazard ratios (HR) for primary outcomes across five dedicated heart failure trials of SGLT2 inhibitors The forest plot presents hazard ratios (HR) with 95% confidence intervals for heart failure hospitalization (HF hospitalization), cardiovascular death (CV death), and the primary composite outcome in the DAPA-HF, EMPEROR-Reduced, SOLOIST-WHF, EMPEROR-Preserved, and DELIVER trials. The horizontal reference line at HR=1.0 indicates null effect, with values below this line (HR<1.0) demonstrating statistically significant risk reduction. The y-axis scale (0.0-1.0) quantifies the degree of risk reduction across trials. Data were extracted from references [15-19].

Fig.3 Comparison of cardiovascular outcomes between SGLT2 inhibitor monotherapy and combination regimens The forest plot displays hazard ratios (HR) with 95% confidence intervals for primary outcome, hospitalization for heart failure, and cardiovascular mortality across three treatment regimens: SGLT2 inhibitor monotherapy, ARNI+MRA+SGLT2i combination, and ARNI+BB+MRA+SGLT2i intensive combination. The vertical reference line at HR=1.0 indicates null effect, with values to the left (<1.0) demonstrating statistically significant risk reduction. The x-axis scale reveals a consistent gradient of incremental benefit from monotherapy to combination regimens across all clinical endpoints.Data were extracted from reference [26].