The use of sodium-glucose cotransporter 2 inhibitors in heart failure with reduced or preserved ejection fraction: new guidelines hot off the press and directly into guidelines!

Postgrad Med J. 2023 Sep 21;99(1176):1052-1057. doi: 10.1093/postmj/qgad022.

Abstract

It is well known that the prevalence of heart failure (HF) is high and continues to grow. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, although initially developed as a therapy for type 2 diabetes, have been found to be beneficial in patients with HF, regardless of diabetic status. Given the clinical benefit demonstrated in recent large randomized clinical trials in those with HF, they have been rapidly incorporated into clinical practice and adopted by the national guidelines hot off the press. SGLT2 inhibitors are now recommended for patients with symptomatic HF, with any ejection fraction. These medications are generally very well tolerated by patients, and adverse effects include genital and soft tissue infections, euglycemic ketoacidosis, and volume depletion. SGLT2 inhibitors have now become a pillar of the pharmacologic treatment of HF, thus providers should be familiar with their use for not only those with type 2 diabetes, but also those with HF.

Keywords: drug therapy; evidence-based medicine; heart failure; sodium-glucose cotransporter 2 inhibitors; therapeutics.

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucose
  • Heart Failure* / drug therapy
  • Humans
  • Sodium
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects
  • Stroke Volume

Substances

  • Sodium-Glucose Transporter 2 Inhibitors
  • Glucose
  • Sodium