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Review
. 2019 Apr;14(1):23-32.
doi: 10.15420/ecr.2018.34.2.

Sodium-glucose Cotransporter 2 Inhibitors in Heart Failure: Potential Mechanisms of Action, Adverse Effects and Future Developments

Juan Tamargo  1
Affiliations
Review

Sodium-glucose Cotransporter 2 Inhibitors in Heart Failure: Potential Mechanisms of Action, Adverse Effects and Future Developments

Juan Tamargo. Eur Cardiol. 2019 Apr.

Erratum in

Abstract

Heart failure is a common complication in patients with diabetes, and people with both conditions present a worse prognosis. Sodium-glucose cotransporter 2 inhibitors (SGLT2Is) increase urinary glucose excretion, improving glycaemic control. In type 2 diabetes (T2D), some SGLT2Is reduce major cardiovascular events, heart failure hospitalisations and worsening of kidney function independent of glycaemic control. Multiple mechanisms (haemodynamic, metabolic, hormonal and direct cardiac/renal effects) have been proposed to explain these cardiorenal benefits. SGLT2Is are generally well tolerated, but can produce rare serious adverse effects, and the benefit/risk ratio differs between SGLT2Is. This article analyses the mechanisms underlying the cardiorenal benefits and adverse effects of SGLT2Is in patients with T2D and heart failure and outlines some questions to be answered in the near future.

Keywords: Type 2 diabetes; cardiovascular outcome trials; heart failure; safety profile; sodium-glucose cotransporter inhibitors; sodium–glucose cotransporter.

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Conflict of interest statement

Disclosure: JT received no direct or indirect compensation related to the development of the manuscript. This work was supported by grants from the Instituto de Salud Carlos III [PI16/00398 and CIBER-Cardiovascular (CB16/11/00303)] and Comunidad de Madrid (B2017/BMD-3738).

Figures

Figure 1:
Figure 1:. Potential Mechanisms Involved in the Cardioprotective and Renoprotective Effects of Sodium–glucose Cotransporter 2 Inhibitors
See this image and copyright information in PMC

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