Update on evidence-based clinical application of sodium-glucose cotransporter inhibitors: Insight to uncommon cardiovascular disease scenarios in diabetes

Table 2 Summary of clinical studies on sodium-glucose cotransporter inhibitors in acute heart failure patients

Ref.	Type of article	Journal and published time	Drugs	Aim of study	Inclusive population	Intervention cycle	Number of cases	Main conclusion
Voors et al[26]	RCT	Nat Med, 2022	Empagliflozin (10 mg/d) or placebo	To evaluate whether empagliflozin can improve clinical outcomes when initiated in patients who are hospitalized for AHF	Patients with AHF or decompensated chronic HF	90 d	530	Empagliflozin results in significant clinical benefit in patients hospitalized for AHF
Biegus et al[27]	RCT	Eur Heart J, 2023	Empagliflozin (10 mg/d) or placebo	To evaluate effects of the SGLT2i empagliflozin on decongestion-related endpoints in the EMPULSE trial	Patients with AHF or decompensated chronic HF	90 d	530	Empagliflozin in patients hospitalized for AHF resulted in an early, effective, and sustained decongestion
Kosiborod et al[28]	RCT	Circulation, 2022	Empagliflozin (10 mg/d) or placebo	To investigate the effects of the SGLT2i empagliflozin on symptoms, physical limitations, and quality of life, using the KCCQ in the EMPULSE trial	Patients with AHF or decompensated chronic HF	90 d	530	Empagliflozin improved symptoms, physical limitations, and quality of life in patients hospitalized for AHF
Damman et al[29]	RCT	Eur J Heart Fail, 2020	Empagliflozin (10 mg/d) or placebo	To evaluate safety and clinical efficacy of SGLT2is in patients with acute decompensated HF	AHF patients with and without diabetes	30 d	80	Empagliflozin increased urinary output and reduced a combined endpoint of worsening HF, rehospitalization for HF, or death at 60 d
Charaya et al[30]	RCT	Open Heart, 2022	Dapagliflozin (10 mg/d in addition to standard therapy)	To evaluate safety and clinical efficacy of the SGLT2i dapagliflozin in patients with acute decompensated HF	Patients with AHF	30 d	102	Dapagliflozin did not improve the in-hospital and 30-d prognosis after discharge
Carvalho et al[31]	Meta- Analysis	Clin Res Cardiol, 2023	Dapagliflozin (10 mg/d), empagliflozin (10/25 mg/d), sotagliflozin (200-400 mg/d), or placebo	To compare cardiovascular outcomes, renal function, and diuresis in patients receiving standard diuretic therapy for AHF with or without the addition of SGLT2i	Patients with AHF	30 d to 2.3 years	2824	SGLT2i combined conventional diuretic therapy can reduce all-cause death, readmissions for HF, and the composite results

AHF: Acute heart failure; EMPULSE: Empagliflozin in Patients Hospitalized with Acute Heart Failure Who Have Been Stabilized; HF: Heart failure; KCCQ: Kansas City Cardiomyopathy Questionnaire; NT-proBNP: N-terminal pro B-type natriuretic peptide; SGLT2i: Sodium-glucose co-transporter-2 inhibitors; AHF: Acute heart failure.