SCIENTIFIC JOURNAL of the Hungarian Society of Cardiology

SGLT2 inhibitors on cardiovascular outcomes

█ Review

DOI: 10.26430/CHUNGARICA.2023.53.4.360

Kosztin Annamária
Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
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Sodium-glucose transporter 2 (SGLT2)-inhibitors are proved to be effective antidiabetic drugs in type 2 diabetes mellitus (T2DM) and are associated with improved glycemic control, reduced body mass and blood pressure. In large, randomized placebo-controlled trials, SGLT2 inhibitors improved the cardiovascular and renal outcomes in patients with heart failure thoughout the full spectrum of the ejection fraction regardless of the diabetic status. The possible mechanisms of benefit are being extensively investigated because they are unlikely to be related to improved glycaemic control. Early natriuresis with a reduction in plasma volume, improved vascular function, a reduction in blood pressure and changes in tissue sodium are all likely to have a role. Additional mechanisms include a reduction in adipose tissue-mediated inflammation, a shift towards ketone bodies as the metabolic substrate, reduced oxidative stress, lowered serum uric acid level and reduced glomerular hyperfiltration. Further studies with patiens with heart failure with preserved ejection fraction and non-diabetic kidney disease will provide even more information about the exact mechanism of action of SGLT2 inhibitors.


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