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SGLT2i and Heart Failure
SGLT2 Inhibitor Use in People With Heart Failure

Released: August 23, 2024

Expiration: August 22, 2025

Javed Butler
Javed Butler, MD, MPH, MBA
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Key Takeaways
  • Approval of SGLT2i for the prevention and treatment of heart failure represents a major shift in the medical management of this disease.

On Monday, September 30, 2024, I will be part of a symposium at the Heart Failure Society of America Annual Scientific Meeting 2024 (HFSA 2024) in Atlanta, Georgia, focused on providing expert guidance on sodium–glucose cotransporter 2 inhibitor (SGLT2i) use across the spectrum of heart failure (HF). I invite you to read more about this topic below and register to join the live, interactive symposium, either in person or virtually.

HF Development and Progression
During the past 10-15 years, we have identified specific pathophysiologic events, such as myocardial infarctions, that directly contribute to the development of HF. In addition, some pathophysiologic factors are more related to the progression of HF rather than its onset. Certain factors are unique to HF with reduced ejection fraction, whereas others pertain to HF with preserved ejection fraction. However, there are also common pathways that play a role in both the development and progression of HF, regardless of a person’s ejection fraction.

SGLT2i and HF
Therapies that target higher levels of HF pathophysiology, such as SGLT2i, affect cardiac, renal, and vascular structure and function, as well as inflammation, oxidative stress, adiposity, endothelial function, and fibrosis. These therapies have become invaluable assets, capable of reducing the risk of HF development in high-risk patients and improving outcomes in those with diagnosed HF, regardless of ejection fraction.

It took us a decade to prove this, but we have achieved it with SGLT2i. Studies have shown that in people with type 2 diabetes or chronic kidney disease (with or without diabetes), SGLT2i prevent HF. These are the first drugs proven to improve HF outcomes regardless of ejection fraction.

SGLT2i and Outcomes in People With HF
All the outcomes examined in clinical trials of people with HF—cardiovascular death, hospitalization for HF, estimated glomerular filtration rate preservation, and quality of life—were improved with use of SGLT2i.

The Ideal Drug for People With HF
If a health professions student asked me, “What is an ideal treatment for HF?” I would say it would be a single drug taken once daily, with a quick onset of action and no need for dose titration. It should improve clinical outcomes and quality of life, be well tolerated, and benefit multiple other medical conditions.

What I have just described perfectly matches the characteristics and benefits of SGLT2i.

The Future of HF Management
Given the proven benefits of SGLT2i in people with HF, it is imperative for us as healthcare professionals to ensure that all eligible patients receive this class of medications promptly.

We will delve deeper into the use of SGLT2i in patients with HF at our interactive panel discussion-based symposium at HFSA 2024. Topics will include real-world evidence for SGLT2i use in patients with HF, approaches for integrating SGLT2i into treatment plans, and strategies for patient counseling about the benefits and adverse effects of SGLT2i. Join us in person or via live simulcast to hear expert faculty share perspectives and recommendations on managing patient cases.

Your Thoughts?
How often do you prescribe SGLT2i for your patients with HF? Join the discussion by posting a comment.

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How often do you prescribe SGLT2i for your patients with heart failure?

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