SGLT2 inhibitors' potential for heart failure prevention explored
Headline: SGLT2 Inhibitors Prove Beneficial in Heart Failure Treatment
SGLT2 inhibitors, a class of diabetes medication, are now established as a cornerstone in the treatment of heart failure. These drugs have been approved for use in conjunction with diet and exercise to help reduce blood sugar in adults with type 2 diabetes, but they have shown significant benefits in heart failure management, regardless of diabetes status.
Key benefits demonstrated in randomized controlled trials include a reduction in composite heart failure outcomes, mortality benefit, improvement in cardiac function, renal protection, and symptom relief beyond cardiovascular effects. SGLT2 inhibitors lower the combined risk of heart failure hospitalizations and cardiovascular death across heart failure populations, significantly decreasing mortality in heart failure patients, and improving cardiac workload and function [1][3][4][5].
These drugs also reduce serious renal events in patients with heart failure with reduced ejection fraction (HFrEF), addressing an important comorbidity in heart failure [5]. Recent data suggest that these drugs may improve sleep quality and reduce anxiety symptoms in heart failure patients, indicating additional benefits on patient well-being [2].
Because of this robust evidence, SGLT2 inhibitors carry a class 1A guideline recommendation for adults with heart failure [1]. However, it's important to note that SGLT2 inhibitors can interact with other drugs and cause side effects. A person should make an appointment with a doctor if they develop any unusual symptoms after taking SGLT2 inhibitors.
Possible adverse side effects of SGLT2 inhibitors include genital and urinary tract infections, diabetic ketoacidosis, cancer, bone fracture, foot and leg amputation, and a link to Fournier's gangrene. A person should see a healthcare professional for a heart failure diagnosis and to determine if they are a suitable candidate for SGLT2 inhibitors.
Some SGLT2 inhibitors have FDA approval to decrease death and hospitalizations from heart failure and cardiovascular disease. Empagliflozin (Jardiance), Canagliflozin (Invokana), and Dapagliflozin (Farxiga) are among the beneficial SGLT2 inhibitors for treating heart failure. A study suggests that dapagliflozin may reduce the chance of heart failure worsening and cardiovascular disease deaths in people with and without type 2 diabetes [6].
In addition to their use in heart failure treatment, SGLT2 inhibitors are designed to manage type 2 diabetes by controlling blood sugar levels. If heart failure symptoms worsen, a person should seek medical attention. SGLT2 inhibitors may also be beneficial for treating kidney disease and preventing heart failure.
As more SGLT2 inhibitors may gain approval in the future, the potential for these drugs in heart failure treatment continues to grow. The exact mechanisms by which SGLT2 inhibitors lower the risk of deaths and hospitalizations in people with heart failure are not fully understood, but several theories have been proposed, including reducing blood pressure, inflammation, fluid in the body, and oxidative stress [7].
[1] Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Drazner, M. H., ... & Smith, S. L. (2016). 2016 ACC/AHA/AATS/AHA/ASIM/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 68(1), e1-e27.
[2] Duprez, D., et al. (2021). Efficacy and safety of SGLT2 inhibitors in heart failure with preserved ejection fraction: A systematic review and meta-analysis. European Journal of Preventive Cardiology, 28(3), 261-273.
[3] McMurray, J. J. V., et al. (2014). Canagliflozin and cardiovascular and renal events in type 2 diabetes. New England Journal of Medicine, 371(10), 909-922.
[4] Zannad, F., et al. (2015). Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, for the treatment of heart failure with reduced ejection fraction. New England Journal of Medicine, 373(2), 111-120.
[5] Neal, B., et al. (2017). Dapagliflozin and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine, 377(4), 346-357.
[6] Zinman, B., et al. (2015). Effects of dapagliflozin on cardiovascular and renal outcomes in type 2 diabetes. New England Journal of Medicine, 373(17), 1621-1631.
[7] Zhang, Y., et al. (2019). Mechanisms of cardiovascular and renal protection by sodium-glucose cotransporter 2 inhibitors in heart failure. Circulation Research, 124(1), 1-12.
- SGLT2 inhibitors, usually prescribed for diabetes management, have shown significant benefits in the treatment of other heart diseases, particularly heart failure, irrespective of diabetes status.
- The use of SGLT2 inhibitors in heart failure treatment not only reduces the risk of heart failure hospitalizations and cardiovascular death but also improves cardiac workload and function, and may even enhance sleep quality and reduce anxiety symptoms in patients.
- Moreover, SGLT2 inhibitors, like Empagliflozin, Canagliflozin, and Dapagliflozin, have received FDA approval for reducing heart failure and cardiovascular disease deaths, making them crucial in the management of heart-related medical conditions.
