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Current 24 - Support for SGLT2i Use in Heart Failure with Preserved Ejection Fraction



Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a key medication option for patients with type 2 diabetes and are a component of guideline-directed medical therapy for patients with heart failure with reduced ejection fraction (HFrEF).1  

A 2022 meta-analysis published in The Lancet analyzed data from five clinical trials, including the DELIVER trial and the EMPEROR-Preserved trial, provides data to support the use of SGLT2i in heart failure with both reduced and preserved ejection fraction, independent of diabetes status.2-4  SGLT2i were found to reduce the risk of the composite and individual outcomes for cardiovascular death and hospitalization for heart failure; all-cause mortality was also reduced. Among all five trials, treatment with SGLT2i reduced the risk of cardiovascular death or hospitalization for heart failure, with a number needed to treat of 25. This meta-analysis adds to the growing evidence supporting SGLT2i use in heart failure across the spectrum of heart failure severity and patient characteristics.2  


  1. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. J Am Coll Cardiol. 2022;79(17):e263-e421.
  2. Vaduganathan M, Docherty KF, Claggett BL, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. Lancet. 2022;400(10354):757-767. doi:10.1016/S0140-6736(22)01429-5.
  3. Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2022;387(12):1089-1098. doi:10.1056/NEJMoa2206286.
  4. Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038.


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