Sodium-glucose cotransporter type 2 inhibitors: revolution in chronic heart failure treatment

Type 2 diabetes mellitus (T2DM) and chronic heart failure (CHF) are multidisciplinary diseases associated with an extremely unfavorable prognosis and high mortality. In presence of T2DM, the course of CHF is characterized by greater severity, early disability and an increased frequency of hospitalizations, which often leads to premature mortality. Large clinical studies dealing with cardiovascular outcomes (CVOT) assessing have demonstrated significant organ-protective properties of sodium-glucose cotransporter type 2 inhibitors in patients with T2DM. For the first time these studies revealed the possibility of reducing overall and cardiovascular mortality, as well as hospitalization due to CHF in patients with and without T2DM. Expansion of indications for the use of sodium-glucose cotransporter type 2 inhibitors marked a significant breakthrough in the treatment of heart failure, which, in its turn led to the formation of a new therapeutic paradigm covering all patients with CHF, regardless of the etiology, stage of the disease and the value of the left ventricular ejection fraction. This resulted in the achievement of a clinically significant improvement in the prognosis and an increase in life quality of patients. Now it is officially reflected in the updated clinical guidelines of the world’s leading cardiological societies, including the European Society of Cardiology, American Heart Association and Russian Society of Cardiology.