Cardiology Department, University Hospital Ospedali Riuniti, Foggia, Italy.
Department of Medicine, Di Lorenzo Clinic, Avezzano, Italy.
Heart Fail Rev. 2022 Jul;27(4):1147-1163. doi: 10.1007/s10741-021-10107-8. Epub 2021 Jun 7.
Despite recent advances in chronic heart failure (HF) therapy, the prognosis of HF patients remains poor, with high rates of HF rehospitalizations and death in the early months after discharge. This emphasizes the need for incorporating novel HF drugs, beyond the current approach (that of modulating the neurohumoral response). Recently, new antidiabetic oral medications (sodium-glucose cotransporter 2 inhibitors (SGLT2i)) have been shown to improve prognosis in diabetic patients with previous cardiovascular (CV) events or high CV risk profile. Data from DAPA-HF study showed that dapaglifozin is associated with a significant reduction in mortality and HF hospitalization as compared with placebo regardless of diabetes status. Recently, results from EMPEROR-Reduced HF trial were consistent with DAPA-HF trial findings, showing significant beneficial effect associated with empagliflozin use in a high-risk HF population with markedly reduced ejection fraction. Results from the HF with preserved ejection fraction trials using these same agents are eagerly awaited. This review summarizes the evidence for the use of gliflozins in HF treatment.
尽管慢性心力衰竭 (HF) 治疗最近取得了进展，但 HF 患者的预后仍然不佳，出院后早期 HF 再住院和死亡的发生率很高。这强调了需要采用新型 HF 药物，而不仅仅是当前的方法（即调节神经激素反应）。最近，新的抗糖尿病口服药物（钠-葡萄糖共转运蛋白 2 抑制剂 (SGLT2i)）已被证明可改善有既往心血管 (CV) 事件或高 CV 风险特征的糖尿病患者的预后。DAPA-HF 研究的数据表明，与安慰剂相比，达格列净可显著降低死亡率和 HF 住院率，无论糖尿病状态如何。最近，EMPEROR-Reduced HF 试验的结果与 DAPA-HF 试验的结果一致，表明在射血分数明显降低的高危 HF 人群中，使用恩格列净可带来显著的有益效果。使用这些相同药物的射血分数保留的 HF 试验的结果正在急切等待中。这篇综述总结了使用格列净治疗 HF 的证据。
