SGLT2 INHIBITORS IN HEART FAILURE: CURRENT EVIDENCE ON EFFICACY, SAFETY, AND PROGNOSTIC IMPACT

Abstract

Heart failure (HF) is a complex clinical condition characterized by the heart’s inability to pump blood effectively to meet the body’s metabolic demands. In recent years, sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially indicated for the treatment of type 2 diabetes mellitus, have demonstrated significant therapeutic benefits in the management of HF, regardless of diabetic status. This literature review aims to analyze the most recent clinical evidence on the effects of SGLT2i in heart failure, with an emphasis on outcomes such as cardiovascular mortality, hospitalizations, and quality of life. The research was conducted in the PubMed, SciELO, and Google Scholar databases, including publications from 2019 to 2024. The findings show that drugs such as dapagliflozin and empagliflozin significantly reduce HF hospitalizations and cardiovascular mortality, in addition to improving patients’ functional capacity and quality of life. The mechanisms of action of these agents go beyond glycemic control and include diuretic effects, reduced ventricular filling pressure, improved endothelial function, and anti-inflammatory activity. International guidelines already recognize and recommend SGLT2i as part of the standard treatment for HF. It is concluded that these drugs represent a highly relevant therapeutic innovation, with a positive impact on the clinical outcomes of patients with heart failure.