Frontiers in Cardiovascular Drug Discovery

Volume: 5

The Role of SGLT2i in the Prevention and Treatment of Heart Failure

Author(s): Hasan AlTurki, Ahmed AlTurki, Mark Sherman, Abhinav Sharma and Thao Huynh * .

Pp: 36-64 (29)

DOI: 10.2174/9789811413247120050004

* (Excluding Mailing and Handling)

Abstract

Diabetes mellitus (DM) is an important independent risk factor for incident heart failure (HF). DM is also a prominent prognostic factor for major cardiovascular (CV) adverse events in patients with established HF with reduced (HFrEF) or preserved ejection fraction (HFpEF). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recently approved drugs for DM treatment. SGLT2i lead to natriuresis and glycosuria with subsequent reductions in blood glucose, intravascular volume, and blood pressure. SGLT2i demonstrated a remarkable relative risk reduction in hospitalization for heart failure in large CV outcome trials of patients with DM. In addition, there was a more modest but also a relevant reduction in CV mortality with empagliflozin. SGLT2i reduce recurrent myocardial infarctions in patients with prior myocardial infarction. SGLT2i were subsequently evaluated in patients with HFrEF, including those without DM. Dapagliflozin was associated with reductions in the primary composite endpoint of worsening heart failure or CV death and each component separately. Considering their remarkable CV benefits and nephroprotection, SGLT2i represent invaluable therapy for the primary and secondary prevention of heart diseases in patients with DM or HFrEF. Ongoing trials may confirm the potential impact of SGTL2i in patients with HFpEF and acutely decompensating HF.


Keywords: Diabetes Mellitus, Heart Failure, SGLT2 Inhibitors.

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      • 11. app/Models/ContentAccess.php:647
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      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51739267 and j.to_ip >=51739267 )) and ((j.from_date <= 1740497466 and j.to_date >= 1740497466 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14021) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51739267 and j.to_ip >=51739267 )) and ((j.from_date <= 1740497466 and j.to_date >= 1740497466 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14021) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51739267 and j.to_ip >=51739267 )) and ((j.from_date <= 1740497466 and j.to_date >= 1740497466 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14021)
      760μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 2818 and `b`.`banner_from_date` <= 1740497466 and `b`.`banner_to_date` >= 1740497466 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.29msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 2818
      • 3: 1740497466
      • 4: 1740497466
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='78673619a3c58bc4a1d3a30024ee9c1e'
      220μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    3Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
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        6AglKz1870vtEN3vLm7A8oXw2wgAa6pZDBibzeY8
        uc_cart_id
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        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/14021" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
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        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Tue, 25 Feb 2025 15:31:06 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlRhSzJLclVIcWRpVkczZzNxVUZzR1E9PSIsInZhbHVlIjoid2JyKzRCc1MvN2lFU3FBdTVRMk5PbmJZVmlORi9hMWw2YmkxaHY2N2E4TlR3ZU1Mdk4zMzhQMFFGZXRWMWI2ZUVlU0JNYXZZdXNJRUI1ZzNsSzVBT1dDSmJrcDVWbWM0Wk9VY0xMMWNzTzNRUGhmV2RVQ3dyWmtkZ0RJenRBMVYiLCJtYWMiOiI1OWEzNjBkNzFkZTZmNTVlZDBlYTdlYzQwODAwMjQwYTYxMDlhZmM3MzVmOWVkZjJiNjg3MGRjNDliMDc0MmU0IiwidGFnIjoiIn0%3D; expires=Fri, 28 Feb 2025 03:31:06 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IlRhSzJLclVIcWRpVkczZzNxVUZzR1E9PSIsInZhbHVlIjoid2JyKzRCc1MvN2lFU3FBdTVRMk5PbmJZVmlORi9hMWw2YmkxaHY2N2E4TlR3ZU1Mdk4zMzhQMFFGZXRWMWI2ZUVlU0JNY" 1 => "alphaeurekaselectnet_session=eyJpdiI6InArQkhHK29NN0RiSEFINnNqaFo1Znc9PSIsInZhbHVlIjoiK0FIMUpMTGpCTUJPUGNlVnFYRjNQNmlJbWVnRzNFWlpFRU1Nb0E2S2RMUGNZN2dqM0UwMG43cEdGUUtncWEwQVU4aWFKbDhBb3RNNFpCVTJUZkZhRlI2MDRQSzBaMWxTcW1TeDkzYlpZVFlsbEZlOXBXeEdNbDNvNGk5ZXVlYkwiLCJtYWMiOiJkZWNhZTY1MTk5MjkyOGM4Yzg5ZGEwZDhhMzI3NTI1MzkzZjMwZGY2MDhiODEyNzAxYjgzYzQ4YzM3MDI3MGYxIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6InArQkhHK29NN0RiSEFINnNqaFo1Znc9PSIsInZhbHVlIjoiK0FIMUpMTGpCTUJPUGNlVnFYRjNQNmlJbWVnRzNFWlpFRU1Nb0E2S2RMUGNZN2dqM0UwMG43cEd" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlRhSzJLclVIcWRpVkczZzNxVUZzR1E9PSIsInZhbHVlIjoid2JyKzRCc1MvN2lFU3FBdTVRMk5PbmJZVmlORi9hMWw2YmkxaHY2N2E4TlR3ZU1Mdk4zMzhQMFFGZXRWMWI2ZUVlU0JNYXZZdXNJRUI1ZzNsSzVBT1dDSmJrcDVWbWM0Wk9VY0xMMWNzTzNRUGhmV2RVQ3dyWmtkZ0RJenRBMVYiLCJtYWMiOiI1OWEzNjBkNzFkZTZmNTVlZDBlYTdlYzQwODAwMjQwYTYxMDlhZmM3MzVmOWVkZjJiNjg3MGRjNDliMDc0MmU0IiwidGFnIjoiIn0%3D; expires=Fri, 28-Feb-2025 03:31:06 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IlRhSzJLclVIcWRpVkczZzNxVUZzR1E9PSIsInZhbHVlIjoid2JyKzRCc1MvN2lFU3FBdTVRMk5PbmJZVmlORi9hMWw2YmkxaHY2N2E4TlR3ZU1Mdk4zMzhQMFFGZXRWMWI2ZUVlU0JNY" 1 => "alphaeurekaselectnet_session=eyJpdiI6InArQkhHK29NN0RiSEFINnNqaFo1Znc9PSIsInZhbHVlIjoiK0FIMUpMTGpCTUJPUGNlVnFYRjNQNmlJbWVnRzNFWlpFRU1Nb0E2S2RMUGNZN2dqM0UwMG43cEdGUUtncWEwQVU4aWFKbDhBb3RNNFpCVTJUZkZhRlI2MDRQSzBaMWxTcW1TeDkzYlpZVFlsbEZlOXBXeEdNbDNvNGk5ZXVlYkwiLCJtYWMiOiJkZWNhZTY1MTk5MjkyOGM4Yzg5ZGEwZDhhMzI3NTI1MzkzZjMwZGY2MDhiODEyNzAxYjgzYzQ4YzM3MDI3MGYxIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6InArQkhHK29NN0RiSEFINnNqaFo1Znc9PSIsInZhbHVlIjoiK0FIMUpMTGpCTUJPUGNlVnFYRjNQNmlJbWVnRzNFWlpFRU1Nb0E2S2RMUGNZN2dqM0UwMG43cEd" ] ]
        session_attributes
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        array:5 [ "_token" => "6AglKz1870vtEN3vLm7A8oXw2wgAa6pZDBibzeY8" "uc_cart_id" => "78673619a3c58bc4a1d3a30024ee9c1e" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/14021" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-25 15:31:06GET/chapter/14021112195