July 22, 2025NEJM Evidence2 citations

Which Patients with Heart Failure Benefit from an SGLT2 Inhibitor?

Key Points

SGLT2 inhibitors notably reduce heart failure events and cardiovascular deaths in clinical trials.
Evidence supports the use of SGLT2i regardless of type 2 diabetes status, leading to strong treatment recommendations.
Despite robust data, the adoption of SGLT2i in clinical practice has been slower than anticipated.
The article reviews trials, benefits, and risks associated with SGLT2i usage in heart failure management.

Abstract

AbstractRandomized controlled trials have demonstrated a reduction in the composite of heart failure events and death from cardiovascular causes with use of SGLT2 inhibitors, regardless of whether a patient has type 2 diabetes mellitus. This evidence led to a class 1A indication for SGLT2i for adults with heart failure. However, recent data demonstrate that the adoption of SGLT2i into practice has been slow. This article describes benefits, risks, pivotal trials, prescribing pearls, and areas of uncertainty related to the use of SGLT2i for adults with heart failure.

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Benjamen et al. (Tue,) studied this question.

synapsesocial.com/papers/689a061be6551bb0af8cd8e8 https://doi.org/https://doi.org/10.1056/evidccon2400446