Sodium–Glucose Co-Transporter 2 Inhibitors in Heart Failure: Beyond Glycaemic Control. A Position Paper of the Heart Failure Association of the European Society of Cardiology
Petar Seferović, Gabriele Fragasso, Mark C. Petrie, Wilfried Müllens, Roberto Ferrari, Thomas Thum, Johann Bauersachs, Stefan D. Anker, Robin Ray, Yüksel Çavuşoğlu, Marija Polovina, Marco Metra, Giuseppe Ambrosio, Krishna Prasad, Jelena P. Seferović, Pardeep S. Jhund, Giuseppe Dattilo, Jelena Čelutkienė, Massimo Piepoli, Brenda Moura, Ovidiu Chioncel, Tuvia Ben Gal, Stefan Heymans, Rudolf A. de Boer, Tiny Jaarsma, Loreena Hill, Yu. M. Lopatin, Alexander R. Lyon, Piotr Ponikowski, Mitja Lainščak, Ewa A. Jankowska, Christian Mueller, Francesco Cosentino, Lars H. Lund, Gerasimos Filippatos, Frank Ruschitzka, Andrew J.S. Coats, Giuseppe Rosano
Abstract
Heart failure (HF) is common and associated with a poor prognosis, despite advances in treatment. Over the last decade cardiovascular outcome trials with sodium-glucose co-transporter 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus have demonstrated beneficial effects for three SGLT2 inhibitors (empagliflozin, canagliflozin and dapagliflozin) in reducing hospitalisations for HF. More recently, dapagliflozin reduced the risk of worsening HF or death from cardiovascular causes in patients with chronic HF with reduced left ventricular ejection fraction, with or without type 2 diabetes mellitus. A number of additional trials in HF patients with reduced and/or preserved left ventricular ejection fraction are ongoing and/or about to be reported. The present position paper summarises recent clinical trial evidence and discusses the role of SGLT2 inhibitors in the treatment of HF, pending the results of ongoing trials in different populations of patients with HF.