SGLT2 inhibitors may be an effective option for patients with diabetes who are at high risk for heart failure or who already have heart failure. They are the first class of glucose-lowering agents associated with a reduced risk of developing heart failure in patients with diabetes and a reduced risk for hospitalization from heart failure. Multiple trials are underway to test SGLT2 inhibitors as a treatment for heart failure in patients with or without diabetes.
There is currently no evidence that DPP-4 inhibitors can offer significant cardiovascular benefit.
Thiazolidinedione drugs are not recommended for patients with pre-existing heart failure. In addition, for patients who have diabetes but not heart failure, the use of thiazolidinedione drugs may actually compound the risk for heart failure events.
GLP-1 receptor agonists had no influence on the risk for heart failure hospitalization in patients with diabetes large clinical trials, suggesting that these agents are safe to use among this patient population but are not an effective heart failure prevention strategy.
For additional information, refer to the following clinical practice guidelines:
2019 European Society of Cardiology (ESC) Clinical Practice Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases Developed in Collaboration with the European Association for the Study of Diabetes (EASD)
2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America
2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure)
2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
2019 ACC Expert Consensus Decision Pathway on Risk Assessment, Management, and Clinical Trajectory of Patients Hospitalized With Heart Failure
European Society of Cardiology (ESC) Acute and Chronic Heart Failure Guidelines
Learn more about the treatment for heart failure.
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Cite this: Romesh Khardori, Yasmine S. Ali. Fast Five Quiz: Type 2 Diabetes and Heart Failure - Medscape - Feb 15, 2022.