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Cardio-Protective Effects of Sodium-Glucose Co-Transporter 2 Inhibitors: Focus on Heart Failure

Dimos Karangelis1, C David Mazer2, Dimitrios Stakos3

  • 1Department of Cardiac Surgery, Mitera Hospital, 6 Erythrou Stavrou Street, 15123, Marousi, Athens, Greece.

Current Pharmaceutical Design
|November 4, 2020
PubMed
Abstract

Insights

Sodium-glucose co-transporter 2 (SGLT2) inhibitors show significant heart failure benefits for patients with or without type 2 diabetes. These drugs reduce cardiovascular events and hospitalizations through various mechanisms, including diuresis and improved cardiac energetics.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (DM) significantly increases cardiovascular and renal disease risk, particularly heart failure.
  • Sodium-glucose co-transporter 2 (SGLT2) inhibitors demonstrate remarkable cardiorenal protective effects in diverse patient populations.
  • These benefits are observed in patients with or without diabetes, established cardiovascular disease, or multiple cardiovascular risk factors.

Purpose of the Study:

  • To review the role of SGLT2 inhibitors in improving heart failure outcomes.
  • To elucidate the proposed mechanisms of action behind the beneficial effects of SGLT2 inhibitors.

Main Methods:

  • Comprehensive literature search of PubMed, Embase, and Google Scholar databases.
  • Identification and summarization of eligible articles discussing SGLT2 inhibitors and heart failure.
  • Focus on mechanisms and clinical outcomes.

Main Results:

  • Key mechanisms include diuresis, natriuresis, reduced preload/afterload, decreased ventricular mass, erythropoietin stimulation, and enhanced myocardial energetics.
  • SGLT2 inhibitors improve outcomes in patients with established heart failure (HF).
  • These agents reduce mortality and HF hospitalizations in chronic heart failure with reduced ejection fraction (HFrEF), irrespective of diabetes status.

Conclusions:

  • SGLT2 inhibitors offer significant cardioprotective benefits, with potential mechanisms outlined.
  • Class Ia recommendations support SGLT2 inhibitors for reducing HF hospitalizations and mortality in specific type 2 diabetes groups.
  • The benefits of SGLT2 inhibitors may extend to non-diabetic individuals, with ongoing research into their use in acute cardiovascular episodes.
Keywords:
SGLT2 inhibitorsantidiabeticscardioprotective effectscardiovascular eventsdiabetes mellitusheart failure

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