Current and Emerging Data on SGLT2 Inhibitors in Heart Failure
Published: 03 December 2019
The opportunity for cardiovascular disease prevention in patients with type 2 diabetes mellitus (T2DM) has recently expanded with antihyperglycemic agents demonstrating significant reductions in the risk of major adverse cardiovascular events (MACE) including sodium-glucose co-transporter-2 (SGLT2) demonstrating robust reductions in heart failure (HF). Although the exact mechanisms of cardiovascular (CV) benefit remain uncertain, they appear to be unrelated to the direct glucose-lowering effects.
Recent trials — including the recently presented DAPA-HF — have provided further insight into the effectiveness of SGLT2 inhibitors in patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) in the absence of T2DM.
- Understand the SGLT2 inhibitor cardiovascular outcome trial (CVOT) data; differentiate the latest guideline updates for the treatment of T2D
- Consider comorbidities, including atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF)
- Apply clinical and real-world evidence of the SGLT2 inhibitor class for use in prevention of hospitalisation in HF, as well as future ongoing studies in the treatment of HF
- Assess the interrelationships linking diabetes, HF and CVD
- Interpret the potential cardio-renal mechanisms of the SGLT2 inhibitor class in reducing the risk of CV, including HF.
- Evaluate emerging data of the treatment of HF with SGLT2 inhibitors in patients with or without T2DM.
Guidelines, Recent Data & Future Practices
Andrew JS Coats
Director of the Monash Warwick Alliance and Academic Vice-President
Prof Andrew Coats is President of the Heart Failure Association and Professor of Cardiology, University of Warwick, UK. He is an Australian-British academic cardiologist and inventor. Prof Coats' main interest is heart failure.
From 2012 to 2017 he was Director of the Monash-Warwick Alliance, and before that served as Deputy Vice-Chancellor and Dean of Medicine of the University of Sydney.
He is an Australian-British academic cardiologist as well as a successful fundraiser, university administrator and inventor.
Prof Coats is Editor-in-Chief of the Cardiac Failure Review editorial board.
Professor and Senior Consultant
Prof Carolyn Lam is a Senior Consultant at the Department of Cardiology and Director of Women's Heart Health at the National Heart Centre Singapore, having pioneered the first Women’s Heart Clinic in Singapore. Prof Lam is a world-renowned specialist in heart failure (particularly heart failure with preserved ejection fraction [HFpEF]). Her work in the PARAGON-HF and EMPEROR-Preserved trials led to the first FDA-approved treatment for HFpEF and the first robustly positive clinical outcomes trial in HFpEF to-date.