Roles of Empagliflozin in Diabetic Cardiomyopathy: A Review

Empagliflozin (EMPA), a sodium-glucose cotransporter 2 inhibitor (SGLT2i), represents a novel therapeutic agent for diabetes management. Over the past decade, studies have consistently demonstrated that EMPA not only effectively lowers blood glucose levels but also confers substantial cardiovascular benefits without inducing hypoglycemia. This holds for individuals with or without diabetes, highlighting EMPA's potential in mitigating the risk of adverse cardiovascular events and cardiovascular mortality. The underlying mechanisms driving these advantageous effects remain incompletely understood, with presently elucidated pathways encompassing blood pressure reduction, oxidative stress attenuation, anti-inflammatory properties, metabolic regulation, uric acid level modulation, inhibition of Na+/H+ exchangers, preservation of mitochondrial function, vascular protection, and regulation of myocardial autophagy. In this review, we considered the effects and mechanisms of EMPA in combating diabetic cardiomyopathy (DCM), underscoring its therapeutic relevance in addressing cardiovascular complications associated with diabetes.