Efficacy and Safety of Sodium-Glucose Cotransporter-2 in the Treatment for Heart Failure with Reduced Ejection Fraction

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Dhorn Amnuayphonwiwat

Abstract

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors including dapagliflozin and empagliflozin have been currently used to treat heart failure patients with reduced ejection fraction (HFrEF). This class of drug is effective in reducing mortality from coronary heart disease, and rate of hospital admissions in heart failure patients with or without diabetes as comorbidity and having the New York Heart Association Functional Classification at the level 2-4. These drugs should be used in conjunction with the main drug for treating of HFrEF. These drugs have been used in heart failure patients with diabetes mellitus according to the clinical practice guidelines for diagnosing and treating patients with heart failure. Adverse reactions to this group of drugs include urinary tract infections and genital mycotic infections, dehydration and electrolyte imbalance. Therefore, the efficacy and safety of these drugs should be monitored in order to achieve the best therapeutic effect in patients.

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Research Articles

References

Virani S, Alonso A, Benjamin E, Bittencourt M, Callaway C, Carson A, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation 2020; 141: e139-e596. doi: 10.1161/CIR.0000000000000757.

Moleerergpoom W, Hengrussamee K, Piyayotai D, Jintapakorn W, Sukhum P, Kunjara-Na-Ayudhya R, et al. Predictors of in-hospital mortality in acute decompensated heart failure (Thai ADHERE). J Med Assoc Thai 2013; 96: 157-64.

Phrommintikul A, Buakhamsri A, Janwanishstaporn S, Sanguanwong S, Suvachittanont N. Heart Failure Council of Thailand (HFCT) 2019 heart failure guideline: acute heart failure. J Med Assoc Thai 2019; 102: 373-9.

Maddox T, Januzzi J, Allen L, Breathett B, Butler J, Davis L, et al. American College of Cardiology 2021 update to the 2017 ACC expert consensus decision pathway for optimization of heart failure treatment. J Am Coll Cardiol 2021; 77: 772-810.

Lam CSP, Chandramouli C, Ahooja V, Verma S. SGLT‐2 Inhibitors in heart failure: current manage ment, unmet needs, and therapeutic prospects. J Am Heart Assoc 2019; 8: e013389.

Anon. Dapagliflozin. In: In depth answers [database on the internet]. Greenwood Village (CO): IBM Corporation; 2021 [cited Aug 4, 2021]. Available from: www.micromedexsolutions.com.

McMurray J, Solomon S, Inzucchi S, Køber L, Kosiborod M, Martinez F, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med 2019; 381: 1995-2008.

Nassif M, Windsor S, Tang F, Khariton Y, Husain M, Inzucchi S, et al. Dapagliflozin effects on biomarkers, symptoms, and functional status in patients with heart failure with reduced ejection fraction. Circulation. 2019; 140:1463–76.

Anon. Empagliflozin. In: In depth answers [data base on internet]. Greenwood Village (CO): IBM Corporation; 2021 [cited Aug 4, 2021]. Available from: www.micromedexsolutions.com.

Anker S, Butler J, Filippatos G, Khan M, Marx N, Lam C, et al. Empagliflozin outcome trial in patients with chronic heart failure and a reduced ejection fraction. Circulation 2021; 143: 337-49.

Zannad F, Ferreira JP, Pocock SJ, Anker SD, Butler J, Filippatos G, et al. SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPAHF trials. Lancet 2020; 396: 819-29.

Diabetes Association of Thailand. Diabetes clinical practice guideline 2017. 3rd ed. Bangkok: Romyen Publication; 2017.