SGLT2 inhibitors – a new pillar for the treatment of heart failure

Česká verzia

Authors: Dominika Tavačová; Jan Václavík
Authors place of work: Interní a kardiologická klinika, Fakultní nemocnice Ostrava a Lékařská fakulta Ostravské univerzity, Ostrava
Published in the journal: Vnitř Lék 2021; 67(8): 475-478
Category: Review Articles

Summary

DAPA-HF and EMPEROR-REDUCED clinical trials have shown significant benefits of dapagliflozin and empagliflozin in the treatment of heart failure with reduced ejection fraction regardless of the presence or absence of diabetes mellitus. Their results support the implementation of SGLT2 inhibitors into clinical practice in patients with heart failure, due to their efficacy, safety, and minimal side effects. Their mechanism of action does not depend on the state of neurohumoral activation and SGLT2 inhibitors have a simple dosing regimen, without the need for dose titration. In addition to cardioprotective properties, SGLT2 inhibitors also have a very significant nephroprotective effect. Empagliflozin and dapagliflozin have recently been approved by regulatory authorities for the treatment of adults with symptomatic chronic heart failure with reduced ejection fraction and are becoming one of the basic pillars of treatment for these patients.

Keywords:

dapagliflozin – empagliflozin – heart failure - gliflozins – STLT2 inhibitors

Zdroje

1. Táborský M, Kautzner J, Linhart A et al. Chronické srdeční selhání. V Kardiologie. Mladá fronta, 2017; 738–749. ISBN 978-80-204-4434-9.

2. Špinar J, Špinarová L, Vítovec J. Dapagliflozin a srdeční selhání. Cor Vasa 2020; 62: 618-623.

3. Špinar J, Špinarová L, Vítovec J. Intervenční a akutní kardiologie 2020; 19(4): 238–241.

4. Špinar J, Špinarová L, Vítovec J, Kardiol. Rev. Int Med 2017;19 (3): 195–200.

5. McMurray JJV, Solomon SD, Inzucchi SE et al. DAPA‑HF Trial Committees and Investigators. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019 Nov 21; 381(21): 1995–2008.

6. Packer M, Anker SD, Butler J et al. EMPEROR‑Reduced Trial Investigators. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020 Oct 8; 383(15): 1413–1424.

7. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599–3726. doi: 10.1093/eurheartj/ehab368. Erratum in: Eur Heart J. 2021 Oct 14: PMID: 34447992.