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World J Diabetes. Jul 15, 2024; 15(7): 1461-1476
Published online Jul 15, 2024. doi: 10.4239/wjd.v15.i7.1461
Update on evidence-based clinical application of sodium-glucose cotransporter inhibitors: Insight to uncommon cardiovascular disease scenarios in diabetes
Shi-Bing Tao, Xi Lu, Zi-Wei Ye, Nan-Wei Tong
Shi-Bing Tao, Xi Lu, Zi-Wei Ye, Nan-Wei Tong, Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Shi-Bing Tao, Xi Lu, Nan-Wei Tong, Research Centre for Diabetes and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Shi-Bing Tao, Department of Endocrinology and Metabolism, Ziyang Central Hospital, Ziyang 641300, Sichuan Province, China
Author contributions: Tao SB and Tong NW contributed to conceptualization and methodology; Tao SB, Lu X, and Ye ZW contributed to writing of the original manuscript; Tao SB contributed to manuscript review and editing; Tong NW contributed to supervision; all authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nan-Wei Tong, BMed, MD, MSc, Chief Physician, Director, Professor, Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu 610041, Sichuan Province, China. tongnw@scu.edu.cn
Received: February 20, 2024
Revised: April 28, 2024
Accepted: May 29, 2024
Published online: July 15, 2024
Processing time: 139 Days and 17.4 Hours
Abstract

In this paper, we concentrate on updating the clinical research on sodium-glucose cotransporter inhibitors (SGLTis) for patients with type 2 diabetes who have heart failure with a preserved injection fraction, acute heart failure, atrial fibrillation, primary prevention of atherosclerotic cardiovascular disease/cardiovascular disease, and acute myocardial infarction. We searched the data of randomized controlled trials and meta-analyses of SGLTis in patients with diabetes from PubMed between January 1, 2020 and April 6, 2024 for our review. According to our review, certain SGLTis (empagliflozin, dapagliflozin, canagliflozin, and tofogliflozin), but not sodium-glucose cotransporter 1 inhibitor (SGLT1i), exhibit relatively superior clinical safety and effectiveness for treating the abovementioned diseases. Proper utilization of SGLTis in these patients can foster clinical improvement and offer an alternative medication option. However, clinical trials involving SGLTis for certain diseases have relatively small sample sizes, brief intervention durations, and conclusions based on weak evidence, necessitating additional data. These findings are significant and valuable for providing a more comprehensive reference and new possibilities for the clinical utilization and scientific exploration of SGLTis.

Keywords: Sodium-glucose cotransporter inhibitors; Diabetes; Heart failure; Atrial fibrillation; Atherosclerosis; Cardiovascular disease; Acute myocardial infarction

Core Tip: In this paper, we concentrate on updating the clinical research on sodium-glucose cotransporter inhibitors (SGLTis) for patients with type 2 diabetes who have heart failure with a preserved injection fraction, acute heart failure, atrial fibrillation, primary prevention of atherosclerotic cardiovascular disease/cardiovascular disease, and acute myocardial infarction. We review the data from randomized controlled trials and meta-analyses of SGLTis in patients with diabetes from PubMed for our review. Previous studies have indicated that certain SGLTis (empagliflozin, dapagliflozin, canagliflozin, and tofogliflozin), but not sodium-glucose cotransporter 1 inhibitor (SGLT1i), exhibit relatively superior clinical safety and effectiveness for treating the abovementioned diseases. Proper utilization of SGLTis in these patients can foster clinical improvement and offer an alternative medication option for these conditions.