Key result
SGLT2 inhibitors demonstrate significant cardioprotective benefits, particularly in reducing heart failure hospitalizations and cardiovascular mortality, in patients with and without type 2 diabetes.
Why the study?
SGLT2 inhibitors offer protection against HF-related events and cardiovascular mortality independent of glycaemic control, warranting an evidence-based review of their outcomes, mechanisms, and clinical practice impact.
Do SGLT2 inhibitors reduce cardiovascular events and heart failure hospitalizations in patients with type 2 diabetes and/or heart failure?
Do SGLT2 inhibitors reduce cardiovascular events and heart failure hospitalizations in patients with type 2 diabetes and/or heart failure?
SGLT2 inhibitors provide significant cardiovascular and renal benefits, particularly in reducing heart failure hospitalizations, representing a major paradigm shift in the management of patients with type 2 diabetes and heart failure.
May support SGLT2 inhibitor use in nondiabetic HF; leaves open confirmation via dedicated large RCTs.
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new drug class designed to treat patients with type 2 diabetes (T2D). However, cardiovascular outcome trials showed that SGLT2i also offer protection against heart failure (HF)-related events and cardiovascular mortality. These benefits appear to be independent of glycaemic control and have recently been demonstrated in the HF population with reduced ejection fraction (HFrEF), with or without T2D. This comprehensive, evidence-based review focuses on the published studies concerning HF outcomes with SGLT2i, discussing issues that may underlie the different results, along with the impact of these new drugs in clinical practice. The potential translational mechanisms behind SGLT2i cardio-renal benefits and the information that ongoing studies may add to the already existing body of evidence are also reviewed. Finally, we focus on practical management issues regarding SGLT2i use in association with other T2D and HFrEF common pharmacological therapies. Safety considerations are also highlighted. Considering the paradigm shift in T2D management, from a focus on glycaemic control to a broader approach on cardiovascular protection and event reduction, including the potential for wide SGLT2i implementation in HF patients, with or without T2D, we are facing a promising time for major changes in the global management of cardiovascular disease.
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Brito et al. (2020) conducted a review in Heart failure and Type 2 diabetes. SGLT2 inhibitors vs. Placebo or standard of care was evaluated. SGLT2 inhibitors demonstrate significant cardioprotective benefits, particularly in reducing heart failure hospitalizations and cardiovascular mortality, in patients with and without type 2 diabetes.
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