SGLT-2 inhibitors in the treatment of heart failure with reduced ejection fraction

Abstract

Introduction: Heart failure (HF) is a clinical syndrome characterized by decreased left ventricular ejection fraction. The use of sodium-glucose transporter 2 inhibitors (ISGLT2) in patients with HF showed efficacy in reducing mortality and hospitalization.
Methodology: A bibliographic survey was carried out in the main databases, analyzing the benefits of ISGLT2 in the main high-impact journals.
Discussion: EMPAREG showed a lower mortality in the use of empaglifozin compared to the group that received the placebo (3.7% vs. 5.7%). The canagliflozin study, CANVAS, showed a 14% lower risk of cardiovascular death in patients without cardiovascular disease (CVD), whereas in patients with known CVD, it decreased by 18%. DECLARE-TIMI 58 showed that in patients with DM2 there is a lower risk of HF and death from cardiovascular events among patients who used Dapaglifozin compared to patients who received placebo (4.9% vs. 5.8). In DAPA HF, the number of deaths from cardiovascular causes was 9.7% vs 11.5% of patients who took placebo. In EMPEROR-REDUCED, with Empaglifozin, the primary endpoint occurred in 361 of 1863 patients (19.4%) in the drug group against 462 of 1867 patients (24.7%) in the placebo group. SOLOIST-WHF, analyzing the drug Sotagliflozin, observed the occurrence of a primary outcome in 245 patients in the drug group and 355 in the placebo group.
Conclusion: Patients with HF have gained a new drug class for their treatment, being even mentioned in the most recent guidelines around the world, still needing more studies to test it efficacy in HF with preserved ejected fraction.