Overview of Sodium-Glucose Co-transporter 2 (SGLT2) Inhibitors for the Treatment of Non-diabetic Heart Failure Patients.

Irina Balan,Sevara Sultanova,Yuliia Lomakina,Tetyana Khayo

doi:10.7759/cureus.17118

Abstract

Heart failure (HF) is a clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood, and results in low life quality and expectancy, creating a significant burden on the healthcare system. The pharmacological HF management has remained unchanged for a decade, however, several randomized clinical trials have demonstrated the potential clinical benefits of sodium-glucose cotransporter-2 inhibitors, an antidiabetic agent, by reducing the rate of hospitalizations for HF, cardiovascular death, and all-cause death. The cardioprotective effects are characterized by reduction of inflammatory, metabolic and ionic dyshomeostasis despite the diabetic status. Since the United States Food and Drug Administration (FDA) approval in May 2020, SGLT2 inhibitors have been used mostly in heart failure with reduced ejection fraction (HFrEF). In this review article, we provide a comprehensive overview of the potential benefits, effectiveness, and safety profile of SGLT2 inhibitors used in HF patients with no history of diabetes mellitus.

Highlights

BackgroundHeart failure (HF) is a clinical syndrome that comprises fatigue, dyspnea, reduced exercise tolerance, and fluid retention as a result of a deterioration of ventricular filling and/or ejection fraction [1]
We provide a comprehensive overview of the potential benefits, effectiveness, and safety profile of sodium-glucose cotransporter 2 (SGLT2) inhibitors used in HF patients with no history of diabetes mellitus
A new approach to pharmacological treatment of HF was implemented in May 2020 with the approval of sodium-glucose cotransporter 2 (SGLT2) inhibitors by the Food and Drug Administration (FDA) for the treatment of adults with heart failure with reduced ejection fraction with and without type 2 diabetes mellitus (T2DM) to mitigate the risk of cardiac mortality and admissions due to HF and associated disorders [8]

Summary

Introduction

Heart failure (HF) is a clinical syndrome that comprises fatigue, dyspnea, reduced exercise tolerance, and fluid retention as a result of a deterioration of ventricular filling and/or ejection fraction [1]. A new approach to pharmacological treatment of HF was implemented in May 2020 with the approval of sodium-glucose cotransporter 2 (SGLT2) inhibitors (dapagliflozin) by the FDA for the treatment of adults with heart failure with reduced ejection fraction with and without type 2 diabetes mellitus (T2DM) to mitigate the risk of cardiac mortality and admissions due to HF and associated disorders [8]. There is a multitude of clinical trials investigating the potential use of SGLT2 inhibition in HF patients with and without T2DM [4]. At this time the effectiveness and safety profile of SGLT2 inhibitors in patients with chronic heart failure without diabetes mellitus remains incompletely understood [10].

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Disclosures