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Sodium-glucose co-transporter 2 inhibitors and heart failure—the present and the future

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Abstract

Type 2 diabetes mellitus is associated with an increased risk of heart failure. The prevalence of type 2 diabetes mellitus is on an upward trend. Heart failure represents one of the major causes for hospitalisation and mortality despite advances in management. Recent cardiovascular outcome trials have demonstrated that sodium-glucose co-transporter 2 inhibitors, which were introduced to the market in 2013, can incur a clinically significant risk reduction in heart failure outcomes in such patients. In this review, we discuss the epidemiology and pathophysiology of heart failure in diabetes and explore the landmark trials, the potential mechanisms of benefit of SGLT-2 inhibitors in heart failure, how the trials have led to major changes in treatment guidelines, and future potential directions for use of these drugs, including in those without diabetes.

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Authors and Affiliations

  1. Diabetes and Endocrinology Department, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, Wales, LL13 7TD, UK

    Melanie Nana & L. N. Rao Bondugulapati

  2. Cardiology Department, Royal Glamorgan Hospital, Llantrisant, Wales, CF72 8XR, UK

    Holly Morgan

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  1. Melanie Nana
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The idea for this article was formulated by Dr. L N Rao Bondugulapati, the literature review was carried out by all three authors, Dr. M Nana and Dr. H Morgan drafted the work, and it was then critically revised by Dr. L N Rao Bondugulapati.

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Correspondence to Melanie Nana.

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Nana, M., Morgan, H. & Bondugulapati, L.N.R. Sodium-glucose co-transporter 2 inhibitors and heart failure—the present and the future. Heart Fail Rev 26, 953–960 (2021). https://doi.org/10.1007/s10741-020-09925-z

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