AN UPDATE ON CURRENT USAGE OF SGLT2-INHIBITORS IN HEART FAILURE WITH REDUCED EJECTION FRACTION: SPECIAL FOCUS ON DAPAGLIFLOZIN

Abstract

Heart failure (HF) is a complex clinical syndrome resulting from impairment of ventricular
filling or ejection of blood. Management of patients with HF still remains a clinical challenge and
many current therapies have uncertain impacts on long-term morbidity and mortality. Sodium-glucose
co-transporter 2 inhibitors (SGLT2i) were initially developed for their glucose-lowering effect and
subsequently have been shown to decrease the risk of Hospitalization for Heart Failure (HHF). After
the initial Cardiovascular Outcome Trials (CVOTs) new data have provided the evidence of benefits of
these agents in reducing cardiovascular mortality and HHF in patients with Heart Failure with reduced
ejection fraction (HFrEF) with or without co-existing Type 2 Diabetes (T2DM). In this narrative
review, we have summarized the current therapies in the management of heart failure and clinical
evidences with SGLT2i with special focus on Dapagliflozin for clinical outcomes in HFrEF patients.
We have also reviewed the latest guidelines that have proposed the use of SGLT2i in the management
of HFrEF.