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Sodium-Glucose Cotransporter Inhibitors in Non- Diabetic Heart Failure: A Narrative Review

Ranjan Dahal1, Yogesh Acharya2, Debabrata Mukherjee1

  • 1Division of Cardiology, Department of Internal Medicine, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, EL Paso, TX 79905, United States.

Cardiovascular & Hematological Disorders Drug Targets
|January 4, 2021
PubMed

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors show promise for managing non-diabetic heart failure (HF). These drugs may improve cardiovascular outcomes and functional status in patients without diabetes, with a favorable safety profile observed in recent trials.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Heart failure (HF) presents a significant global health challenge, exacerbated by rising risk factors like hypertension and obesity.
  • Despite efforts in prevention and management, HF continues to impose a substantial burden on healthcare systems worldwide.

Purpose of the Study:

  • To investigate the clinical role and implications of sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with non-diabetic heart failure.
  • To synthesize evidence from recent clinical trials on the efficacy and safety of SGLT2 inhibitors in this specific patient population.

Main Methods:

  • A comprehensive literature review was conducted using PubMed and Embase databases.
  • Focused analysis on two randomized controlled trials (RCTs): DAPA-HF and DEFINE-HF, evaluating dapagliflozin in non-diabetic HF.

Main Results:

  • Both DAPA-HF and DEFINE-HF demonstrated promising clinical outcomes for SGLT2 inhibitors in non-diabetic HF.
  • DAPA-HF showed a Number Needed to Treat (NNT) of 21 to prevent a primary event.
  • DEFINE-HF reported significant improvements in functional status (KCCQ-OS by 3.7, KCCQ-CS by 4.6 points) with NNTs of 10 and 7, respectively, and noted low safety concerns.

Conclusions:

  • SGLT2 inhibitors appear to offer significant clinical benefits for managing non-diabetic heart failure.
  • Emerging evidence suggests potential for improved cardiovascular outcomes in this patient group.
  • Further prospective RCTs are warranted to confirm these findings and safety profiles.
Abstract

Keywords:
SGLT-2 inhibitorsSodium-glucose transporter 2 inhibitorscongestive heart failuredapagliflozindisease management.systolic heart failuretype 2 diabetes mellitus

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