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Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure

Mieczysław Dutka1, Rafał Bobiński2, Izabela Ulman-Włodarz2

  • 1Faculty of Health Sciences, Department of Biochemistry and Molecular Biology, University of Bielsko-Biała, Willowa St. 2, 43-309, Bielsko-Biała, Poland. mdutka@ath.bielsko.pl.

Heart Failure Reviews
|November 5, 2020
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) offer significant cardiovascular benefits for diabetic patients with heart failure (HF). These drugs reduce mortality and HF hospitalizations, independent of glucose control, potentially treating HF in the future.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes mellitus is a major risk factor for heart failure (HF) development and prognosis.
  • Intensive glycemic control in diabetic HF patients has not shown direct prognostic improvement.
  • Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are a novel class of antidiabetic drugs.

Purpose of the Study:

  • To review the current understanding of SGLT2 inhibitors' mechanisms of action.
  • To explore the cardioprotective effects of SGLT2 inhibitors in diabetic patients.
  • To discuss the potential future use of SGLT2 inhibitors in heart failure treatment.

Main Methods:

  • Review of recent clinical trials on SGLT2 inhibitors in diabetic patients.
  • Analysis of experimental studies investigating SGLT2 inhibitors' mechanisms.
  • Synthesis of current knowledge on SGLT2 inhibitors' cardioprotective effects.

Main Results:

  • SGLT2 inhibitors significantly reduced cardiovascular and all-cause mortality in diabetic patients.
  • SGLT2 inhibitors led to fewer hospitalizations due to heart failure compared to placebo.
  • Observed clinical benefits were rapid and not solely attributed to improved glycemic control.

Conclusions:

  • SGLT2 inhibitors demonstrate significant cardioprotective effects beyond glycemic control.
  • These findings have already influenced clinical practice for high-CV-risk diabetic patients.
  • SGLT2 inhibitors show promise as a future treatment for heart failure.

Keywords:
Cardiovascular diseasesDiabetesHeart failureSodium-glucose cotransporter 2 inhibitors

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