The contemporary role of sodium-glucose co-transporter 2 inhibitor (SGLT2i) and angiotensin receptor-neprilysin inhibitor (ARNI) in the management of heart failure: State-of-the-art review.

Babu Ezhumalai, Ranjan Modi, Manokar Panchanatham, Dhamodaran Kaliyamoorthy

Journal: Indian heart journal 2024;76(4):229-239

PMID: 39009078

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Abstract

Novel therapies for heart failure with reduced ejection fraction (HFrEF) are angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose co-transporter 2 inhibitor (SGLT2i), etc. The purpose of this review is to determine the effects of ARNI and SGLT2i in heart failure (HF), compare the impact of SGLT2i with ARNI, and finally evaluate the current data regarding the combination of these two drugs in HF. Various trials on the respective medications have shown some significant reduction in all-cause mortality and cardiovascular (CV) death. The combination of these drugs has shown more CV benefits than monotherapy. There is emerging data about these two drugs in patients with heart failure with preserved ejection fraction (HFpEF). At present, there are less head-to-head comparison trials of these two drugs. This review provides insights on the current evidence, comparative efficacy, and combination therapy of ARNI and SGLT2i in managing HF, focussing on HFrEF and HFpEF.

Address: Department of Cardiology, Apollo Speciality Hospitals Vanagaram, Chennai, India. Electronic address: [email protected].; Department of Cardiology, Indraprastha Apollo Hospitals, New Delhi, India.; Department of Cardiology, Kauvery Hospital, Vadapalani, Chennai, India.; Department of Cardiology, Apollo Hospitals, Greams Road, Chennai, India.

DOI: 10.1016/j.ihj.2024.07.005