The Serendipitous Story of SGLT2 Inhibitors in Heart Failure
Abstract
The Serendipitous Story of SGLT2 Inhibitors in Heart Failure New Insights From DECLARE-TIMI 58Articles, see p 2516 and p 2528 D iabetes mellitus intersects with cardiovascular disease at every level.Although there has been much focus on understanding atherosclerotic complications, less well appreciated is the relationship between diabetes mellitus and heart failure.In addition to being a key and independent risk factor for the development of heart failure, 1 diabetes mellitus is also one of the most important adverse prognostic factors in those with established heart failure with either reduced or preserved ejection fraction (EF).1,2 Diabetes mellitus is associated with a high prevalence of unrecognized left ventricular diastolic and systolic dysfunction, and it accelerates the development of overt heart failure compared with similar patients without diabetes mellitus.3 In addition to cardiac predictors such as left ventricular dysfunction, hypertrophy, and coronary artery disease, features of diabetes mellitus associated with the development of heart failure include poor glycemic control, longer duration of diabetes mellitus, insulin treatment, and the presence of microvascular complications, such as retinopathy or nephropathy.2,4 Finally, data from randomized trials and registries remind us that heart failure is numerically nearly as common as ischemic complications in patients with type 2 diabetes mellitus and remains one of the leading causes of hospitalizations in this…
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