Review of SGLT2 Inhibitors in Heart Failure with Reduced Ejection Fraction

Rishika Ranjan Saharoy

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a type of per oral antihyperglycemic medicine.It works by reducing glucose i.e. C6H1206 reabsorption in the proximal renal tubules, resulting in increased urine glucose excretion by the human body, which, thereby proving useful in diabetes mellitus. They seem to have a cardiovascular benefit in addition to lowering glucose levels, with mechanisms including eventually lead up to decreased preload and afterload, improved cardiac metabolism and bioenergetics, inhibition of myocardial Na+/H+ exchange, reduction of necrosis and cardiac fibrosis, and changes in adipokines, cytokine production, and in majority of epicardial adipose tissue mass. We, for the most part, give an up-to-date narrative literature overview of SGLT2 inhibitor mechanisms of action, at present definite clinical knowledge, known and researched therapeutic utility, and potential side effects in this review paper, in our own perspective.This narrative review article is based on the gathered information via dedicated and thoroughly conducted CV Outcome trials with SGLT2 inhibitors and related review articles. In October 2022, we used PubMed and Google Scholar to conduct a thorough electronic web search for papers and journals published between January 2000 and October 2022 related to our review. EMPA-REG OUTCOME, DECLARE-TIMI, CANVAS Program, DAPA-HF, and EMPEROR-Reduced are some of the studies that instated that using SGLT2 inhibitors reduced the risk of CV death or hospitalisation due to heart failure with some potential side effects. SGLT2 inhibitors were documented to reduce 3-point MACE (CV mortality, definitely non-fatal MI, non-fatal stroke) by 14 percent in a double-blind, placebo-controlled RCT (phase 3) as per our searched articles. SGLT2 inhibitors are a fairly recent class of antihyperglycemic medication that definitely has been shown to help heart failure with reduced ejection fraction ( HFrEF) patients with and without Type 2 Diabetes Mellitus (T2DM).However, it appears that doctors who are looking after this medically sensitive patient group with HFrEF will be need to be knowledgeable and comfortable with SGLT2 inhibitors.
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