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Abstract : Sodium-glucose co-transporter two inhibitors (SGLT2) present a growing area in the treatment of heart failure. In the literature, the primary focus has been given on the treatment of heart failure in patients with reduced ejection fraction (HFrEF) in other words, (LVEF <40). Several exploratory trials assess the efficacy of SGLT2 inhibitors in the treatment of heart failure with preserved ejection fraction (HFpEF), that is LVEF ≥ 40. We aimed to systematically analyze the effect of SGLT2 inhibitors on HFpEF patients including the primary and secondary outcomes of this therapy. A systematic review and meta-analysis of randomized controlled trials on SGLT2 inhibitors in HFpEF patients has been performed. MEDLINE, EMBASE, PubMed, SCOPUS, and Cochrane databases were searched for trials published up to March 31, 2022. Data was extracted from published studies, and quality assessment was performed as per Cochrane recommendations. Standard mean differences and risk ratios were calculated using the Cochrane handbook for a pooled analysis of the trials. Out of the identified 9,982 database results, 10 randomized trials were included in this meta-analysis. Primary outcomes measured included increased exercise endurance from baseline, the change in the Kansas City Cardiomyopathy Questionnaire (KCCQ-12) responses and outcomes from baseline, all-cause mortality, and the risk of adverse effects. The pooled analysis revealed a standard mean difference of -0.51[-0.60, -0.41], -0.36[-0.78, 0.05], respectively, for exercise endurance and KCCQ-12 responses. Pooled analysis of the risk ratios of 0.97[0.88, 1.07] revealed a minimal reduction of all-cause mortality in the SGLT2 treatment intervention group compared to placebo. A documented risk ratio of 0.97(0.87, 1.08, CI,95%) posed concerns about the safety levels of SGLT2 inhibitors. Heterogeneity across the analysis was insignificant, P<1. The review noted a significant association between SGLT2 inhibitor therapy and improved exercise endurance and KCCQ-12 response. Overall, SGLT2 inhibitors can remarkably reduce heart failure-related hospitalization and urgent hospital visits in HFpEF patients.