SGLT2 inhibitors provide consistent benefits in survival, hospitalizations, and quality of life for patients with heart failure across the spectrum of ejection fraction.
Do SGLT2 inhibitors improve clinical and patient-reported outcomes in patients with heart failure across the spectrum of ejection fraction?
SGLT2 inhibitors are now recognized as foundational disease-modifying therapy for heart failure across the spectrum of ejection fraction, irrespective of diabetes status.
Cardiovascular outcomes trials of sodium-glucose co-transporter-2 (SGLT2) inhibitors have demonstrated consistent signals of benefit in terms of both prevention and treatment of heart failure (HF), in patients with and without type 2 diabetes (T2D). In response to growing evidence of the benefits of SGLT2 inhibitors, including increased survival, reduced hospitalizations and improved patient-reported symptoms, functional status, and quality of life, the treatment landscape for HF has evolved. Importantly, these agents have also demonstrated safety and tolerability in individuals with HF across the spectrum of left ventricular ejection fraction, with improvements in clinical and patient-reported outcomes occurring as early as days to weeks after treatment initiation. For patients with heart failure with reduced ejection fraction (HFrEF), SGLT2 inhibitors are now increasingly recognized as foundational disease-modifying therapy. An updated joint guideline from the American College of Cardiology and American Heart Association now recommends including SGLT2 inhibitors for patients with HF across the spectrum of ejection fraction, irrespective of the presence of diabetes, and regardless of background therapy (Class 1 recommendation for HFrEF, Class 2a recommendation for HF with mildly reduced ejection fraction HFmrEF and HF with preserved ejection fraction HFpEF). The European Society of Cardiology also include a Class I recommendation to use SGLT2 inhibitors for patients with HFrEF to reduce the risk of hospitalization for HF and CV death, irrespective of T2D status. This chapter reviews published clinical trial data about the efficacy and safety of SGLT2 inhibitors among patients with HFrEF, HFpEF, and patients hospitalized for HF.
Greene et al. (Thu,) conducted a review in Heart failure. Sodium-glucose co-transporter-2 (SGLT2) inhibitors was evaluated. SGLT2 inhibitors provide consistent benefits in survival, hospitalizations, and quality of life for patients with heart failure across the spectrum of ejection fraction.