[Current Use of Sodium Glucose Co-transporter 2 Inhibitors in Heart Failure Therapy].

Yüksel Çavuşoğlu, Hakan Altay, Ahmet Çelik, Tolga Sinan Güvenç, Barış Kılıçarslan, Sanem Nalbantgil, Ahmet Temizhan, Özlem Yıldırımtürk, Mehmet Birhan Yılmaz
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Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) inhibit urinary glucose and sodium reabsorption in the proximal tubule of the nephron and result in glucosuria, natriuresis and diuresis. In patients with T2DM who have atherosclerotic cardiovascular (CV) disease or CV risk factors, SGLT2is have been shown to reduce major CV events and heart failure (HF) hospitalization. The greatest and most consistent effect of SGLT2is in these trials was found to be reduction in HF hospitalization, which raised the possibility of clinical benefit of SGLT2i in HF patients. In DAPA-HF and EMPEROR-Reduced trials in HFrEF patients with or without T2DM, SGLT2is, dapagliflozin and empagliflozin treatment on top of standard HF therapy has been shown to have clear clinical benefit in reducing primary endpoint of CV mortality or HF hospitalization and improving quality of life. Recently published EMPEROR-Preserved and DELIVER trials showed that SGLT2is were also very effective in the treatment of HFpEF (EF >40%). Furthermore, SGLT2is have also been shown to have potential in improving clinical outcomes in hospitalized acute HF patients in EMPULSE and DICTATE-AHF trials. All of this evidence has changed guidelines recommended therapies, not only for HFrEF but also for HFpEF treatment. The aim of this article is to provide a comprehensive overview focused on the role of SGLT2i in the treatment of HF based on the recent evidence.

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[葡萄糖钠转运体 2 抑制剂在心力衰竭治疗中的应用现状]。
钠-葡萄糖共转运体-2 抑制剂(SGLT2i)可抑制肾小球近端肾小管对尿液中葡萄糖和钠的重吸收,从而导致糖尿、钠尿和利尿。对于患有动脉粥样硬化性心血管(CV)疾病或有 CV 危险因素的 T2DM 患者,SGLT2is 已被证明可减少主要的 CV 事件和心力衰竭(HF)住院治疗。在这些试验中,SGLT2is 的最大和最一致的效果是减少了心力衰竭的住院治疗,这就提出了 SGLT2i 对心力衰竭患者临床获益的可能性。在针对伴有或不伴有 T2DM 的 HFrEF 患者进行的 DAPA-HF 和 EMPEROR-Reduced 试验中,在标准 HF 治疗的基础上,SGLT2is、dapagliflozin 和 empagliflozin 治疗在降低主要终点(CV 死亡率或 HF 住院率)和改善生活质量方面具有明显的临床获益。最近发表的 EMPEROR-Preserved 和 DELIVER 试验表明,SGLT2is 对治疗 HFpEF(EF >40%)也非常有效。此外,在 EMPULSE 和 DICTATE-AHF 试验中,SGLT2is 还被证明在改善急性心房颤动住院患者的临床预后方面具有潜力。所有这些证据都改变了指南推荐的疗法,不仅适用于 HFrEF,也适用于 HFpEF 治疗。本文旨在根据最新证据全面概述 SGLT2i 在治疗心房颤动中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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