Key result
A narrative review of 8 studies and 2 meta-analyses found highly heterogeneous data but optimistic perspectives for the use of SGLT2 inhibitors in patients with heart failure with preserved ejection fraction.
Why the study?
It remained unclear whether patients with heart failure with preserved ejection fraction or mildly reduced ejection fraction are relevant candidates for effective therapeutic intervention with SGLT2 inhibitors.
Do SGLT2 inhibitors improve clinical outcomes in patients with heart failure with preserved ejection fraction?
Do SGLT2 inhibitors improve clinical outcomes in patients with heart failure with preserved ejection fraction?
This narrative review suggests that while data is heterogeneous and limited by methodological issues, SGLT2 inhibitors show optimistic potential for improving outcomes in patients with HFpEF.
Supports SGLT2 inhibitor initiation in HFpEF; extends quadruple therapy to preserved EF phenotypes.
The conventional conception of the therapy of heart failure (HF) with reduced ejection fraction has been recently modified by adding sodium-glucose co-transporter-2 (SGLT2) inhibitors to the combination consisting of beta blockers, mineralocorticoid receptor antagonists, and angiotensin receptor-neprilysin inhibitors, with the aim of improving clinical outcomes. It remains unclear whether other sub-populations of patients with HF, having either HF with preserved ejection fraction (HFpEF) or HF with mildly reduced ejection fraction, are relevant candidates for the effective therapeutic intervention that includes SGLT2 inhibitors. The purpose of the narrative review is to elucidate plausible perspectives for the clinical implementation of SGLT2 inhibitors into optimal medical therapy in patients with HFpEF. The authors searched the bibliographic databases (Embase, Medline, and the Web of Science) and the Cochrane Central to find English-written publications satisfying the purpose of this study. The authors included eight studies and two meta-analyses that have been reported as completed and found that there were high heterogeneous data regarding the fact that SGLT2 inhibitors had strict resemblance in their efficacy among patients with HFpEF with and without Type 2 diabetes. Due to the use of unpublished data and findings from the trials ended early, there is a lack of upper left ventricular ejection fraction threshold levels to identify inclusion criteria and no agreement in heart failure with reduced ejection fraction determination. However, the results of the meta-analysis, especially come from subgroups’ analysis, appeared to be relevantly optimistic for use of SGLT2 inhibitors in HFpEF therapy.
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Berezin et al. (2022) conducted a review in Heart failure with preserved ejection fraction (HFpEF). SGLT2 inhibitors was evaluated. A narrative review of 8 studies and 2 meta-analyses found highly heterogeneous data but optimistic perspectives for the use of SGLT2 inhibitors in patients with heart failure with preserved ejection fraction.
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