INIBIDORES DO SGLT2 NA INSUFICIÊNCIA CARDÍACA - EFICÁCIA E SEGURANÇA EM DESTAQUE: REVISÃO DE LITERATURA
INIBIDORES DO SGLT2 NA INSUFICIÊNCIA CARDÍACA - EFICÁCIA E SEGURANÇA EM DESTAQUE: REVISÃO DE LITERATURA
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DOI: https://doi.org/10.22533/at.ed.03124170512
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Palavras-chave: Sglt2; insuficiência cadíaca; tratamento.
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Keywords: Sglt2; heart failure; treatment.
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Abstract: The article reviews the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors in heart failure (HF) treatment, focusing on empagliflozin. It highlights these drugs' efficacy in reducing the risk of cardiovascular death, HF hospitalizations, and improving cardiac and metabolic function. Recent studies demonstrate benefits on symptoms, physical limitations, and quality of life in HF patients, regardless of left ventricular ejection fraction (LVEF). 2,533 articles were analyzed, resulting in 63 selected. After exclusions, 18 articles were discussed, addressing the efficacy of SGLT2 inhibitors in HF. Dapagliflozin, another SGLT2 inhibitor, also shows significant improvements in patients with HF with reduced (HFrEF) and preserved (HFpEF) ejection fraction, including cases with pronounced symptomatic and functional impairment. Anemia, common in HF patients, is addressed, highlighting dapagliflozin's correction and prevention of anemia in type 2 diabetes patients, possibly due to its diuretic effect and increased erythropoiesis. The biomarker GDF-15, associated with HF progression and adverse cardiovascular events, is discussed regarding SGLT2 inhibitors, suggesting these drugs may influence its plasma levels. Racial and ethnic variations in HF, especially among Black patients, are considered, emphasizing uncertainty about the benefits of SGLT2 inhibitors in this group. SGLT2 inhibitors also demonstrate cardiac, renal, and metabolic benefits, including reverse cardiac remodeling and improved insulin resistance. In summary, these drugs represent a promising new therapeutic approach for HF, regardless of patients' diabetic status, with the potential to positively impact clinical practice. Further studies are needed to fully understand their mechanisms of action and effects in different populations, especially in Black patients.
- Neusa Aparecida Refrande
- Natalia Barreto e Sousa
- Bruna Fontes Borges Pitanga
- Mislene Gomes da Silva Monsores
- Amanda Maia dos Reis
- Fabio Rodrigo Pirrho de Azevedo