Abstract
In this review, I comment on the recently published review which focuses on sodium-glucose cotransporter-2 Inhibitor (SGLT2i) across the heart failure spectrum with chronic heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Furthermore, it examines the usefulness of SGLT2i in various cardiac diseases such as acute heart failure, acute myocardial infarction, and arrhythmia (sudden cardiac death). This is promising for HFpEF, which has no available effective drugs to date. Many of the studies reported significantly superior primary and secondary endpoints in the SGLT2i group compared with the control group. SGLT2i is indicated for HFrEF and HFpEF as a class 1A recommendation, regardless of the presence of diabetes mellitus or left ventricular ejection fraction. Its effect on cardiovascular outcomes can be viewed as a victory in cardiac disease treatment. However, evidence supporting its use in elderly patients with chronic heart failure, who typically have reduced multiorgan reserves, remains scarce. SGLT2i may achieve a true “triumph” if it demonstrates benefit and safety that outweigh potential harm even in elderly patients with frailty, multimorbidity, and polypharmacy.
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