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Paradigm shift in heart failure treatment: are cardiologists ready to use gliflozins?

Michele Correale1, Renata Petroni2,3, Stefano Coiro4

  • 1Cardiology Department, University Hospital Ospedali Riuniti, Foggia, Italy. opsfco@tin.it.

Heart Failure Reviews
|June 7, 2021
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) show promise in heart failure (HF) treatment. These drugs significantly reduce mortality and hospitalizations, offering new hope for HF patients regardless of diabetes status.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Chronic heart failure (HF) management has limited impact on patient prognosis, evidenced by high rehospitalization and mortality rates post-discharge.
  • Current HF therapies primarily focus on neurohumoral modulation, necessitating novel therapeutic approaches.

Purpose of the Study:

  • To review the emerging evidence for gliflozins (sodium-glucose cotransporter 2 inhibitors) as a novel treatment strategy for heart failure.
  • To assess the impact of SGLT2 inhibitors on mortality and hospitalization in HF patients.

Main Methods:

  • Review of pivotal clinical trials, including DAPA-HF and EMPEROR-Reduced.
  • Analysis of data concerning the efficacy of dapagliflozin and empagliflozin in HF populations.

Main Results:

  • Dapagliflozin demonstrated a significant reduction in mortality and HF hospitalizations compared to placebo in the DAPA-HF trial, irrespective of diabetes status.
  • Empagliflozin showed similar beneficial effects in the EMPEROR-Reduced trial for high-risk HF patients with reduced ejection fraction.

Conclusions:

  • Sodium-glucose cotransporter 2 inhibitors represent a promising new class of drugs for treating heart failure.
  • Further research, including trials for HF with preserved ejection fraction, is anticipated to solidify the role of gliflozins in HF management.

Keywords:
CanagliflozinChronic heart failureDapagliflozinDiabetes mellitusEmpagliflozinGliflozinSodium-glucose cotransporter 2 inhibitors (SGLT2i)

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