Evidence for sglt2 inhibitor therapy in the treatment of heart failure with reduced ejection fraction
Szegedi Tudományegyetem, Belgyógyászati Klinika, Non-Invazív Kardiológiai Részleg, Szeged
The emerge of sodium-glucose co-transporter 2 (SGLT2) inhibitors in the treatment of heart failure with reduced ejection fraction (HFrEF) may be labelled as the most important and most influential success story in recent years. The effectiveness of SGLT2 inhibitors in the treatment of HFrEF are proved by the full spectrum of clinical studies, starting from cardiovascular (CV) outcome studies and their sub-group analyses, through meta-analyses of CV outcome studies and „real-world” data, ending in randomized, placebo controlled, multicentric studies assessing targeted patient populations with HFrEF. All the above studies consistently prove the effect on risk reduction regarding mortality and morbidity of SGLT2 inhibitors, independent of the diabetic status of patients. Based on this data leading scientific societies formulate recommendations even today on the use of SGLT2 inhibitors in preventing hospitalization for heart failure in patients with type 2 diabetes, and recommend specifically dapagliflozin and empagliflozin in symptomatic patients with HFrEF, independent of their diabetic status. The newest clinical guideline on heart failure of the European Society of Cardiology, due in 2021, is also expected to make recommendations on the incorporation of SGLT2 inhibitors into the algorithm of medical treatment of heart failure.