| Autor: |
Çavuşoğlu Y; Department of Cardiology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye., Altay H; Department of Cardiology, Baskent University, Istanbul, Türkiye., Çelik A; Department of Cardiology, Mersin University Faculty of Medicine, Mersin, Türkiye., Güvenç TS; Department of Cardiology, Istinye University Faculty of Medicine, Istanbul, Türkiye., Kılıçarslan B; Department of Cardiology, Health Sciences University, Tepecik Training and Research Hospital, Izmir, Türkiye., Nalbantgil S; Department of Cardiology, Ege University Faculty of Medicine, Izmir, Türkiye., Temizhan A; Department of Cardiology, Health Sciences University, Ankara City Hospital, Ankara, Turkey., Yıldırımtürk Ö; Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Chest Heart and Vascular Surgery Training and Research Hospital, Istanbul, Türkiye., Yılmaz MB; Department of Cardiology, Dokuz Eylul University Faculty of Medicine, Izmir, Türkiye. |
| Abstrakt: |
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) inhibit urinary glucose and sodium reabsorption in the proximal tubule of the nephron and result in glucosuria, natriuresis and diuresis. In patients with T2DM who have atherosclerotic cardiovascular (CV) disease or CV risk factors, SGLT2is have been shown to reduce major CV events and heart failure (HF) hospitalization. The greatest and most consistent effect of SGLT2is in these trials was found to be reduction in HF hospitalization, which raised the possibility of clinical benefit of SGLT2i in HF patients. In DAPA-HF and EMPEROR-Reduced trials in HFrEF patients with or without T2DM, SGLT2is, dapagliflozin and empagliflozin treatment on top of standard HF therapy has been shown to have clear clinical benefit in reducing primary endpoint of CV mortality or HF hospitalization and improving quality of life. Recently published EMPEROR-Preserved and DELIVER trials showed that SGLT2is were also very effective in the treatment of HFpEF (EF >40%). Furthermore, SGLT2is have also been shown to have potential in improving clinical outcomes in hospitalized acute HF patients in EMPULSE and DICTATE-AHF trials. All of this evidence has changed guidelines recommended therapies, not only for HFrEF but also for HFpEF treatment. The aim of this article is to provide a comprehensive overview focused on the role of SGLT2i in the treatment of HF based on the recent evidence. |
