Exploring the Current Selective Drugs of SGLT2 Inhibitors for the Treatment of Cardiovascular Disease in Type 2 Diabetes

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are increasingly studied for their cardiovascular applications beyond heart failure (HF) management. Experimental studies suggest SGLT2i may offer cardioprotective benefits after myocardial infarction (MI), with trials like EMPACT-MI and DAPA-MI assessing effects on heart failure hospitalization and mortality post-MI. Current guidelines from the European Society of Cardiology (ESC) and American Heart Association (AHA) recommend SGLT2i (dapagliflozin and empagliflozin) for treating chronic HF with reduced ejection fraction (HFrEF), independent of diabetes status, to reduce HF hospitalizations and cardiovascular death. The EMPEROR-Preserved and DELIVER trials support extending SGLT2i use to HF with mid-range and preserved ejection fraction (HFmrEF, HFpEF). The American Diabetes Association (ADA) recommends SGLT2i for Type 2 diabetes (T2D) patients at high risk of HF. This medication, taken as a 10 mg daily dose without dose titration, is advised for patients hospitalized with HF, potentially providing rapid benefits within a month.