SGLT2 Inhibitors in Heart Failure: Early Initiation to Achieve Rapid Clinical Benefits

Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a recent addition to the pillars of medical therapy for heart failure (HF) with reduced ejection fraction, all of which improve quality of life, morbidity, and mortality. These benefits are evident within the first 30 days of initiation. This review discusses the rationale for SGLT2i initiation in simultaneous or in rapid sequence with other guideline-directed medical therapy (GDMT). We also discuss SGLT2i use and early benefits in HF patients with an ejection fraction greater than 40%.

Keywords: Guideline-directed medical therapy; Heart failure with preserved ejection fraction; Heart failure with reduced ejection fraction; Initiation and sequencing.