Sodium Glucose Co-Transporters 2 Inhibitors are Useful Addition for Treatment of Heart Failure with Reduced Ejection Fraction | Biomedgrid

Background: Recent well-designed trials have shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors decrease heart failure hospitalization (HFH) in patients with or without type 2 diabetes. Methods: Review of literature (English, French, Spanish) from January 1990 to January 21, 2020. Key words included heart failure, sodiumglucose co-transporter 2, SGLT2 inhibitors, safety, randomized trials, and meta-analysis. Expert opinions and guidelines are also reviewed. Results: The use of SGLT2 inhibitors in patients with type 2 diabetes was associated with significant relative reduction in HFH by 27-35%. The latter reduction is most likely a class effect and is consistent in patients with various degrees of cardiovascular (CV) risk at baseline. In patients with heart failure and reduced ejection fraction (HFrEF), dapagliflozin decreased risk of a composite outcome of worsening heart failure (HF) or CV death by 26%, as well as the secondary outcomes of HFH by 30% and death from any cause by 17%. Moreover, dapagliflozin decreased severity of symptoms of heart failure. Importantly, the amelioration of previous outcomes was similar in patients with or without diabetes. Dapagliflozin did not cause major hypoglycemia in non-diabetic patients with heart failure. However, patients with advanced HFrEF with New York Heart Association (NYHA) class IV were not included. Conclusion: SGLT2 inhibitors should be added to the standard care in most patients with HFrEF in presence or absence of type 2 diabetes.