Paradigm shift in heart failure treatment: are cardiologists ready to use gliflozins?

Michele Correale, Renata Petroni, Stefano Coiro, Elena-Laura Antohi, Francesco Monitillo, Marta Leone, Marco Triggiani, Shiro Ishihara, Hans-Dirk Dungen, Chaudhry M S Sarwar, Maurizio Memo, Hani N Sabbah, Marco Metra, Javed Butler, Savina Nodari

Journal: Heart failure reviews 2022;27(4):1147-1163

PMID: 34097173

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Abstract

Despite recent advances in chronic heart failure (HF) therapy, the prognosis of HF patients remains poor, with high rates of HF rehospitalizations and death in the early months after discharge. This emphasizes the need for incorporating novel HF drugs, beyond the current approach (that of modulating the neurohumoral response). Recently, new antidiabetic oral medications (sodium-glucose cotransporter 2 inhibitors (SGLT2i)) have been shown to improve prognosis in diabetic patients with previous cardiovascular (CV) events or high CV risk profile. Data from DAPA-HF study showed that dapaglifozin is associated with a significant reduction in mortality and HF hospitalization as compared with placebo regardless of diabetes status. Recently, results from EMPEROR-Reduced HF trial were consistent with DAPA-HF trial findings, showing significant beneficial effect associated with empagliflozin use in a high-risk HF population with markedly reduced ejection fraction. Results from the HF with preserved ejection fraction trials using these same agents are eagerly awaited. This review summarizes the evidence for the use of gliflozins in HF treatment.

Address: Cardiology Department, University Hospital Ospedali Riuniti, Foggia, Italy. [email protected].; Department of Medicine, Di Lorenzo Clinic, Avezzano, Italy.; Cardiology, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.; Cardiology Department, Santa Maria della Misericordia University Hospital, Perugia, Italy.; ICCU, Emergency Institute for Cardiovascular Diseases "C.C. Iliescu", Bucharest, Romania.; The University for Medicine and Pharmacy "Carol Davila", Bucharest, Romania.; Cardiology, Emergency Cardiology Unit, University Hospital Policlinico Bari, Bari, Italy.; Cardiology Department, Santissima Annunziata Hospital, Taranto, Italy.; Division of Cardiology, La Memoria" Hospital, Gavardo (Bs), Italy.; Internal Medicine, Cardiology, and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kawasaky, Japan.; Department of Internal Medicine-Cardiology, Charite' Universitäts Medizin, Berlin, Germany.; Pulse Heart Institute, Spokane, WA, 99204, USA.; Stony Brook University, Stony Brook, NY, 11794, USA.; Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.; Department of Medicine, Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA.; Cardiology Section, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.; Department of Medicine, University of Mississippi, Jackson, MS, USA.

DOI: 10.1007/s10741-021-10107-8

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Full Text Sources:

https://doi.org/10.1007/s10741-021-10107-8

MeSH Terms: Cardiologists, Diabetes Mellitus, Type 2, Heart Failure, Humans, Hypoglycemic Agents, Sodium-Glucose Transporter 2 Inhibitors, Stroke Volume