Efficacy of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors in Heart Failure Management: A Narrative Review Efficacy of SGLT2 Inhibitors in Heart Failure

Abstract

Background: Heart failure (HF) remains a leading cause of morbidity and mortality worldwide, requiring effective management strategies. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, originally developed for diabetes, have emerged as promising therapeutic agents for HF.
Objective: This narrative review aimed to evaluate the efficacy of SGLT2 inhibitors in reducing HF hospitalizations, cardiovascular mortality, and secondary outcomes, such as renal function and quality of life in patients with HF.
Methods: A comprehensive literature search was conducted across PubMed, Embase, and Cochrane databases. Randomized controlled trials (RCTs) involving SGLT2 inhibitors in HF patients were included. Primary outcomes were HF hospitalizations and cardiovascular mortality. Secondary outcomes included all-cause mortality, ejection fraction, renal function, and quality of life.
Results: Thirty-eight RCTs with 35,746 patients were analyzed. SGLT2 inhibitors significantly reduced HF hospitalizations (RR: 0.74, 95% CI: 0.68–0.80, p < 0.001) and cardiovascular mortality (RR: 0.86, 95% CI: 0.78–0.95, p = 0.004). Renal function and quality of life improved significantly.
Conclusion: SGLT2 inhibitors are effective in reducing HF hospitalizations and cardiovascular mortality, particularly in HFrEF patients, and improve renal function and quality of life.