Results of SGLT2 inhibitor treatment in patients with Type 2 Diabetes mellitus and heart failure with reduced ejection fraction

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) incidence is increasing all over the world due to obesity. Heart failure (HF) occurs when the functional impairment develops in the myocardium. T2DM may concur with HF and cause its development. The excellent pleiotropic effects of SGLT2 inhibitors within the cardiovascular system make these drugs attractive for the treatment of diabetes in patients with HF. Materials and Methods: Our study population included 21 patients with New York Heart Association (NYHA) classification II to IV with an ejection fraction less than or equal to 40% and type 2 diabetes mellitus. They were enrolled between February 2019 and February 2020. We collected information on age, sex, eGFR, Left ventricular ejection fraction (LVEF) and duration of empagliflozin usage. Addition of once daily 10 mg of empagliflozin to their treatment applied. Results: 21 patients with NYHA classification II to IV with an ejection fraction less than or equal to 40% and type 2 diabetes mellitus were enrolled, 19 were male (90.5%). The mean age of the patients was 60 ± 7.21 (Male: 59.11 ± 7.15; Female: 57.50 ± 10.60). The mean use of empagliflozin was 6.90 ± 4.38 months. The mean LVEF in Ecocardiography was 30.52 ± 9.36%. The difference between pro BNP (p=0.205), total cholesterol (p=0.723), triglyceride (p=0.082), HDL (p=0.778), LDL (p=0.808), Hba1c (p=0.643) levels before and after empagliflozin treatment were not statistically significant (p>0.05). Discussion: Patients with type 2 diabetes and heart failure have been reported to have reduced levels of proBNP and Hba1c with SGLT2 inhibition. In addition, it reduces body weight, blood pressure, CV risk, HF hospitalization. However, in our study, such benefits were not observed in both laboratory and clinical parameters. Large number of patients are needed to research.