Sodium-glucose cotransporter-2 inhibitors in type 2 diabetes: a magic potion to reduce heart failure?

摘要

It is four decades since the Framingham study revealed the strong association between heart failure and type 2 diabetes mellitus (T2DM), with evidence supporting a bidirectional relationship [1,2]. Initially, research focused on the reduction of the risk of new-onset DM with pharmacological agents used in heart failure, notably candesartan, valsartan, ramipril and ena-lapril [2]. This changed in 2015 with the results of the EMPA-REG trial, showing for the first time that a glucose-lowering agent, empagliflozin, reduced the relative risk of hospitalization for heart failure (hHF) by 35% [3]. Thus, sodium glucose co-transporter 2 inhibitors (SGLT-2is), initially developed to target hyperglycemia, began to emerge as potential drugs to prevent heart failure in populations with and without DM [4].