Abstract

Despite advancements in conventional therapies like β-blockers, angiotensin receptor-neprilysin inhibitors, angiotensin-converting enzyme inhibitors, and mineralocorticoid receptor antagonists, Heart Failure (HF) continues to be a global health concern that contributes significantly to morbidity, mortality, and healthcare costs. There is a pressing need for innovative therapeutic approaches since, despite their effectiveness in many situations, these medications frequently fall short of adequately addressing the intricate pathophysiology of HF. Originally created to help control blood sugar levels in people with type 2 diabetes, Sodium-Glucose Linked Transporter-2 (SGLT2) inhibitors have lately shown impressive cardiovascular and renal advantages that go beyond its ability to lower blood sugar levels. Regardless of diabetes status, landmark clinical trials including DAPA-HF, EMPEROR-Reduced, EMPEROR-Preserved, and DELIVER have continuously demonstrated improvements in symptoms, a decrease in hospitalization rates, and a reduction in mortality across a wide range of HF phenotypes. Due to these results, SGLT2 inhibitors have been quickly included in international HF management recommendations, establishing them as a cornerstone treatment in addition to well-known medications. However, there are also issues, such as worries about side effects, cost-effectiveness, practical adherence, and evidence gaps in underrepresented and advanced heart failure patients. With an emphasis on their pharmacological characteristics, molecular insights, clinical evidence, and recommended guidelines, this review explored the changing role of SGLT2 inhibitors in the treatment of heart failure. It also looked at current studies, potential treatment paths, and the wider effects of this paradigm change on clinical practice and cardiovascular health. Findings from this study revealed that SGLT2 inhibitors have shown significant cardiovascular benefits in heart failure management, reducing hospitalizations and mortality. These agents improve cardiac function, reduce inflammation and oxidative stress, and enhance diuresis. Clinical trials demonstrate their efficacy in patients with and without diabetes, shifting the paradigm in heart failure treatment. In conclusion, SGLT2 inhibitors represent a groundbreaking therapeutic approach in heart failure management, offering new hope for improved patient outcomes and reduced healthcare burden.

Keywords:SGLT2 inhibitors; Heart failure; Therapies; Inflammation; Oxidative stress