Dapagliflozin's Role in Heart Failure: An Overview of Clinical Trial Evidence

Abstract

Heart failure (HF) has become a global health threat, necessitating the development of novel treatment options to address this crisis. Sodium-glucose co-transporter-2 (SGLT2) inhibitors, such as dapagliflozin, may offer significant advantages in the treatment of HF, particularly in patients with reduced ejection fraction (HFrEF). This systematic review combines the findings from clinical studies to evaluate the safety and effectiveness of dapagliflozin in HF patients. The study results demonstrate dapagliflozin's consistent improvements in reducing adverse cardiovascular events, including cardiovascular death rates across different HF phenotypes. Mechanistically, dapagliflozin exerts diuretic and hemodynamic effects, along with its actions on myocardial metabolism, ion transporters, fibrosis, adipokines, and vascular function, which collectively contribute to its cardioprotective effects. This overview emphasizes dapagliflozin's key role in HF management, positioning it as one of the central pillars of the HF treatment regimen. Further studies are essential to fully understand dapagliflozin's long-term effectiveness, safety, and integration into routine clinical practice, ultimately improving patient outcomes in HF.

Keywords: dapagliflozin; efficacy; heart failure; sglt2 inhibitors; systematic review.

Figure 1. PRISMA flow diagram representing the study selection process.