Postgraduate Program in Cardiology and Cardiovascular Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul School of Medicine, Porto Alegre, RS, Brazil.
Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Ann Pharmacother. 2021 Oct;55(10):1267-1275. doi: 10.1177/1060028020985111. Epub 2021 Jan 5.
To provide clinical guidance and an overview of the available data on the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors in patients with heart failure with reduced ejection fraction (HFrEF), regardless of the presence of type 2 diabetes mellitus (T2DM).
We searched the MEDLINE database via PubMed (from January 2015 to November 2020) for the following key terms: , and .
To be included in the review, the articles needed to assess the effects of SGLT2 inhibitors in the heart failure (HF) scenario.
There is consistent evidence that SGLT2 inhibitors reduce the risk of major adverse cardiovascular (CV) events and hospitalization in patients with HFrEF, even in the absence of T2DM. On May 5, 2020, the U.S. Food and Drug Administration approved dapagliflozin for adults with HFrEF, regardless of the presence of T2DM, even in those patients on standard therapy, including an angiotensin receptor/neprilysin inhibitor.
The SGLT2 inhibitors are well tolerated, and their once-daily dosing without the need for adjustments is convenient. These drugs can be considered a major breakthrough in pharmacotherapy for HF, providing physicians with a new treatment approach to reduce major clinical outcomes.
SGLT2 inhibitor therapy reduces CV death and hospitalizations in HFrEF patients regardless of T2DM. The decision to prescribe this class of drugs should not be determined by glycemic status.
提供关于钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂在射血分数降低的心力衰竭（HFrEF）患者中的使用的临床指导和现有数据概述，无论是否存在 2 型糖尿病（T2DM）。
我们通过 PubMed 中的 MEDLINE 数据库（从 2015 年 1 月至 2020 年 11 月）搜索了以下关键词：、、。
为了纳入审查，需要评估 SGLT2 抑制剂在心力衰竭（HF）情况下的作用的文章。
有一致的证据表明，SGLT2 抑制剂可降低 HFrEF 患者发生主要不良心血管（CV）事件和住院的风险，即使在没有 T2DM 的情况下也是如此。2020 年 5 月 5 日，美国食品和药物管理局批准达格列净用于 HFrEF 成人患者，无论是否存在 T2DM，即使在接受标准治疗的患者中，包括血管紧张素受体/脑啡肽酶抑制剂。
SGLT2 抑制剂的耐受性良好，且每天一次的给药方式无需调整，使用方便。这些药物可以被认为是 HF 药物治疗的重大突破，为医生提供了一种减少主要临床结局的新治疗方法。
SGLT2 抑制剂治疗可降低 HFrEF 患者的 CV 死亡和住院风险，无论 T2DM 情况如何。开处方时不应根据血糖状况来决定是否使用此类药物。
