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Published on: April 8, 2013
Growing role of SGLT2i in heart failure: evidence from clinical trials
Ajay Varadhan1, Katarina Stephan2, Rahul Gupta3
1Department of Basic Sciences, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA.
Insights
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) show promise for improving heart failure outcomes, regardless of diabetes status. This review explores their role in managing heart failure with preserved ejection fraction (HFpEF).
Area of Science:
- Cardiology
- Pharmacology
- Internal Medicine
Background:
- Heart failure (HF) affects millions, with preserved ejection fraction (HFpEF) representing a significant unmet therapeutic need.
- Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have emerged as a novel therapeutic class with demonstrated cardiovascular benefits.
Purpose of the Study:
- To review the current evidence on the role of SGLT2 inhibitors in managing heart failure.
- To summarize the mechanisms, efficacy, and safety of SGLT2 inhibitors across the spectrum of ejection fractions.
Main Methods:
- Comprehensive literature search of randomized controlled trials involving SGLT2 inhibitors in HF patients.
- Databases searched include PubMed, Google Scholar, Web of Science, and Cochrane Library.
- Screening of studies based on titles and abstracts for relevance.
Main Results:
- SGLT2 inhibitors demonstrate a promising pathophysiological profile for cardioprotection.
- Emerging data suggests efficacy in HF with reduced, mid-range, and preserved ejection fraction.
- Benefits are observed irrespective of diabetes status, highlighting a broader cardiovascular role.
Conclusions:
- SGLT2 inhibitors represent a significant advancement in HF management, offering potential mortality and morbidity benefits.
- Their cardioprotective mechanisms and broad applicability position them as a key therapeutic option for diverse HF populations.
Introduction:
: There is an unmet need for therapies that improve overall mortality and morbidity for patients with preserved ejection fraction, who comprise roughly half of all heart failure (HF) cases. The growing role of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in cardiovascular outcomes provides a paradigm shift in the treatment of HF.
Areas Covered:
: This review article provides a general overview of the growing role of SGLT2is and summarizes the mechanism of action, side effects, and contraindications for the treatment of HF. We also discuss recent clinical trials measuring the effects of different SGLT2is as possible treatment options for HF with reduced ejection fraction and HF with mid-range and preserved EF. We conducted a review of all the randomized, controlled studies with SGLT2is in patients with known heart failure with and without type-2 diabetes (T2DM). We performed a literature search in PubMed, Google Scholar, the Web of Science, and the Cochrane Library while screening results by the use of titles and abstracts.
Expert Opinion:
: The promising pathophysiological profile of SGLT2i and their role in cardioprotective effects demonstrate an invaluable discovery in the management of patients with HF irrespective of their diabetes status.
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