The use of sodium–glucose co-transporter-2 inhibitors in heart failure: a practical overview

Heart failure is a major global healthcare concern. The condition is associated with high morbidity, high mortality and a reduced quality of life. The prognosis of heart failure is poor, with a 5-year survival rate close to 50%. Pharmacological treatment is a cornerstone of heart failure care, helping to improve outcomes and quality of life for people living with the condition. The sodium–glucose co-transporter-2 (SGLT2) inhibitors dapagliflozin and empagliflozin have been approved for patients who have heart failure with reduced ejection fraction, mildly reduced ejection fraction and preserved ejection fraction. This article discusses the evidence base, mechanism of action, clinical indications and practical considerations for the use of SGLT2 inhibitors in the treatment of heart failure.