Department of Cardiovascular Science, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy.
Department of Movement, Human and Health Sciences, University of Rome, Foro Italico, Rome, Italy.
Am J Cardiovasc Drugs. 2023 Nov;23(6):609-621. doi: 10.1007/s40256-023-00601-9. Epub 2023 Aug 24.
Despite continuous advances in both diagnosis and management, heart failure (HF) still represents a major worldwide health issue. Recently, sodium-glucose co-transporter 2 inhibitors (SGLT2i) have demonstrated to reduce cardiovascular death and hospitalization for HF across the entire spectrum of left ventricular ejection fraction. Therefore, dapagliflozin, empagliflozin and sotagliflozin are now recommended as part of the foundational therapy of HF. These agents are characterized by limited contraindications, low cost, non-relevant adverse effects and no need for titration. Although they have a prominent role in the latest recommendations for HF, drug prescriptions are definitely lower than the number of potentially eligible patients. In fact, awareness gaps, therapeutic inertia, concerns about safety and simultaneous initiation of comprehensive medical therapy may represent barriers to their use. This article aims to offer an overview of current knowledge on SGLT2i in HF and provide a comprehensive and updated practical guide on their use in de novo and chronic HF, including potential scenarios that a clinician, cardiologist or others, may face in everyday clinical practice.
尽管在诊断和治疗方面不断取得进展，但心力衰竭（HF）仍然是一个全球性的主要健康问题。最近，钠-葡萄糖协同转运蛋白 2 抑制剂（SGLT2i）已被证明可降低整个左心室射血分数范围内的心血管死亡和心力衰竭住院风险。因此，达格列净、恩格列净和索格列净现在被推荐作为 HF 基础治疗的一部分。这些药物的特点是禁忌症有限、成本低、不良反应不相关，且无需滴定。尽管它们在 HF 的最新推荐中具有重要作用，但药物处方肯定低于潜在合格患者的数量。事实上，意识差距、治疗惰性、对安全性的担忧以及同时开始全面的医学治疗可能是它们使用的障碍。本文旨在概述 SGLT2i 在 HF 中的现有知识，并提供关于其在新发和慢性 HF 中的使用的全面和最新的实用指南，包括临床医生、心脏病专家或其他人员在日常临床实践中可能面临的潜在情况。
