Growing role of SGLT2i in heart failure: evidence from clinical trials

ABSTRACT

Introduction

: There is an unmet need for therapies that improve overall mortality and morbidity for patients with preserved ejection fraction, who comprise roughly half of all heart failure (HF) cases. The growing role of sodium–glucose cotransporter-2 inhibitors (SGLT2is) in cardiovascular outcomes provides a paradigm shift in the treatment of HF.

Areas covered

: This review article provides a general overview of the growing role of SGLT2is and summarizes the mechanism of action, side effects, and contraindications for the treatment of HF. We also discuss recent clinical trials measuring the effects of different SGLT2is as possible treatment options for HF with reduced ejection fraction and HF with mid-range and preserved EF. We conducted a review of all the randomized, controlled studies with SGLT2is in patients with known heart failure with and without type-2 diabetes (T2DM). We performed a literature search in PubMed, Google Scholar, the Web of Science, and the Cochrane Library while screening results by the use of titles and abstracts.

Expert opinion

: The promising pathophysiological profile of SGLT2i and their role in cardioprotective effects demonstrate an invaluable discovery in the management of patients with HF irrespective of their diabetes status.

KEYWORDS:

• SGLT2 inhibitors
• heart failure
• diabetes mellitus
• cardiovascular outcomes

Article highlights

• The growing role of sodium–glucose cotransporter-2 inhibitors (SGLT2i) in cardiovascular outcomes provide a paradigm shift in the treatment of HF.

• This review article provides a general overview of the growing role of SGLT2i and summarizes the mechanism of action, side effects, and contraindications for the treatment of HF.

• We conducted a review of all the randomized, controlled studies with SGLT2i in patients with known heart failure with and without type-2 diabetes (T2DM).

• We discussed recent clinical trials measuring the effects of different SGLT2i as possible treatment options for HF with reduced ejection fraction and HF with mid-range and preserved EF.

• The promising pathophysiological profile of SGLT2i and their role in cardioprotective effects demonstrate an invaluable discovery in the management of patients with HF irrespective of their diabetes status.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This paper was not funded.