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[Role of SGLT2 inhibitors (gliflozins) in heart failure]

André J Scheen1, Arnaud Ancion2, Patrizio Lancellotti2

  • 1Service de diabétologie, nutrition et maladies métaboliques, Unité de pharmacologie clinique, Centre hospitalier universitaire de Liège, Liège Université, 4000 Liège.

Revue Medicale Suisse
|August 25, 2022
PubMed

Insights

Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) significantly reduce heart failure hospitalizations in patients with type 2 diabetes and those without. These findings support SGLT2is as a key therapy for heart failure management.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) have demonstrated cardiovascular benefits in patients with type 2 diabetes.
  • Previous trials indicated SGLT2is reduce heart failure hospitalizations in at-risk populations.

Purpose of the Study:

  • To consolidate the evidence on SGLT2 inhibitors' efficacy in preventing heart failure hospitalizations.
  • To assess the role of SGLT2 inhibitors across different patient profiles, including those with and without diabetes and varying ejection fractions.

Main Methods:

  • Systematic review and analysis of large prospective cardiovascular outcome trials.
  • Inclusion of dedicated trials focusing on heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fraction.

Main Results:

  • SGLT2is consistently reduced heart failure hospitalizations in patients with type 2 diabetes.
  • This benefit was confirmed in dedicated HFrEF trials (DAPA-HF, EMPEROR-reduced) and HFpEF trials (EMPEROR-preserved, DELIVER).
  • The protective effect of SGLT2 inhibitors on heart failure hospitalizations was observed independently of diabetes status.

Conclusions:

  • SGLT2 inhibitors represent a significant therapeutic advancement for heart failure management.
  • Current evidence supports the use of SGLT2 inhibitors in a broad spectrum of heart failure patients, irrespective of diabetes.
  • These findings have influenced recent international guidelines for diabetes and cardiology.

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