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The role of sodium glucose co-transporter inhibitors in heart failure prevention

Vishnu Garla1, Angela Subauste2, Javed Butler3

  • 1Department of Medicine, University of Mississippi Medical Center, Jackson, USA; Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Mississippi Medical Center, Jackson, USA; Mississippi Center for Clinical and Translational Research, University of Mississippi Medical Center, Jackson, USA.

Journal of Diabetes and Its Complications
|December 7, 2020
PubMed

Insights

Sodium-glucose co-transporter-2 (SGLT-2) inhibitors, used for diabetes mellitus, significantly reduce heart failure hospitalizations and cardiovascular mortality. These agents offer cardioprotective benefits beyond glucose control, warranting further investigation.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes mellitus (DM) and heart failure (HF) are globally increasing, with HF being a major complication of DM.
  • DM contributes to HF risk via atherosclerosis and direct myocardial damage.
  • Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are DM treatments that induce glucose excretion.

Purpose of the Study:

  • To review the cardiovascular benefits of SGLT-2 inhibitors in patients with diabetes mellitus.
  • To explore the mechanisms underlying the cardioprotective effects of SGLT-2 inhibitors.
  • To identify areas for future research regarding SGLT-2 inhibitor use in heart failure.

Main Methods:

  • Review of clinical trial data on SGLT-2 inhibitors and cardiovascular outcomes.
  • Analysis of pharmacological properties of SGLT-2 inhibitors relevant to heart failure.
  • Synthesis of evidence on anti-inflammatory, anti-fibrotic, and metabolic effects.

Main Results:

  • SGLT-2 inhibitors consistently reduce HF hospitalization rates and cardiovascular mortality in DM patients.
  • These agents exhibit pleiotropic effects including anti-inflammatory, anti-fibrotic, and antihypertensive properties.
  • Beneficial effects on myocardial metabolism may contribute to HF risk reduction.

Conclusions:

  • SGLT-2 inhibitors demonstrate significant benefits in reducing cardiovascular events and HF in diabetic patients.
  • Their multifaceted mechanisms extend beyond glycemic control, offering direct cardiac protection.
  • Further research is needed to assess SGLT-2 inhibitors in non-diabetic populations and diverse HF phenotypes.

Keywords:
Diabetes mellitusHeart failureSodium glucose co-transporter-2 inhibitors

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