Evidence map›Paper›PMID 29061576›Full record

ReviewCirculation2017

Sodium Glucose Cotransporter-2 Inhibition in Heart Failure: Potential Mechanisms, Clinical Applications, and Summary of Clinical Trials.

Yuliya Lytvyn, Petter Bjornstad, Jacob A Udell, Julie A Lovshin, David Z I Cherney

Open access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 213 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
213citing papers in PubMed, 11 pooled it
30.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

213 citing papers in PubMed, 11 syntheses or guidelines pooled it, 458 citations in OpenAlex.

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  11. Highlights in heart failure.ESC heart failure · 2019
    Pooled it
  12. Trial
  13. Ertugliflozin and Slope of Chronic eGFR: Prespecified Analyses from the Randomized VERTIS CV Trial.Clinical journal of the American Society of Nephrology : CJASN · 2021
    Trial
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153 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Yuliya LytvynFrom Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Ontario, Canada (Y.L., J.A.L., D.Z.I.C.); Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, Aurora (P.B.); Women's College Research Institute and Department of Medicine, Division of Cardiology, Women's College Hospital, University of Toronto, Ontario, Canada (J.A.U.); Peter Munk Cardiac Centre, University Health Network, University of Toronto, Ontario, Canada (J.A.U.); and Department of Medicine, Division of Endocrinology and Metabolism, University Health Network and Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (J.A.L.).
Petter BjornstadFrom Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Ontario, Canada (Y.L., J.A.L., D.Z.I.C.); Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, Aurora (P.B.); Women's College Research Institute and Department of Medicine, Division of Cardiology, Women's College Hospital, University of Toronto, Ontario, Canada (J.A.U.); Peter Munk Cardiac Centre, University Health Network, University of Toronto, Ontario, Canada (J.A.U.); and Department of Medicine, Division of Endocrinology and Metabolism, University Health Network and Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (J.A.L.).
Jacob A UdellFrom Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Ontario, Canada (Y.L., J.A.L., D.Z.I.C.); Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, Aurora (P.B.); Women's College Research Institute and Department of Medicine, Division of Cardiology, Women's College Hospital, University of Toronto, Ontario, Canada (J.A.U.); Peter Munk Cardiac Centre, University Health Network, University of Toronto, Ontario, Canada (J.A.U.); and Department of Medicine, Division of Endocrinology and Metabolism, University Health Network and Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (J.A.L.).
Julie A LovshinFrom Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Ontario, Canada (Y.L., J.A.L., D.Z.I.C.); Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, Aurora (P.B.); Women's College Research Institute and Department of Medicine, Division of Cardiology, Women's College Hospital, University of Toronto, Ontario, Canada (J.A.U.); Peter Munk Cardiac Centre, University Health Network, University of Toronto, Ontario, Canada (J.A.U.); and Department of Medicine, Division of Endocrinology and Metabolism, University Health Network and Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (J.A.L.).
David Z I CherneyFrom Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Ontario, Canada (Y.L., J.A.L., D.Z.I.C.); Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, Aurora (P.B.); Women's College Research Institute and Department of Medicine, Division of Cardiology, Women's College Hospital, University of Toronto, Ontario, Canada (J.A.U.); Peter Munk Cardiac Centre, University Health Network, University of Toronto, Ontario, Canada (J.A.U.); and Department of Medicine, Division of Endocrinology and Metabolism, University Health Network and Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (J.A.L.). david.cherney@uhn.ca.
University Health Network · CAUniversity of Colorado Denver · USWomen's College Hospital · CA

Funding

Training Program in Diabetes ResearchT32DK063687 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI Andrea Steck · 2002 to 2026
$5.2M
NIDDK NIH HHS T32 DK063687
6 · The paper itself

Abstract

Despite current established therapy, heart failure (HF) remains a leading cause of hospitalization and mortality worldwide. Novel therapeutic targets are therefore needed to improve the prognosis of patients with HF. The EMPA-REG OUTCOME trial ([Empagliflozin] Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) demonstrated significant reductions in mortality and HF hospitalization risk in patients with type 2 diabetes mellitus (T2D) and cardiovascular disease with the antihyperglycemic agent, empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor. The CANVAS trial (Canagliflozin Cardiovascular Assessment Study) subsequently reported a reduction in 3-point major adverse cardiovascular events and HF hospitalization risk. Although SGLT2 inhibition may have potential application beyond T2D, including HF, the mechanisms responsible for the cardioprotective effects of SGLT2 inhibitors remain incompletely understood. SGLT2 inhibition promotes natriuresis and osmotic diuresis, leading to plasma volume contraction and reduced preload, and decreases in blood pressure, arterial stiffness, and afterload as well, thereby improving subendocardial blood flow in patients with HF. SGLT2 inhibition is also associated with preservation of renal function. Based on data from mechanistic studies and clinical trials, large clinical trials with SGLT2 inhibitors are now investigating the potential use of SGLT2 inhibition in patients who have HF with and without T2D. Accordingly, in this review, we summarize the key pharmacodynamic effects of SGLT2 inhibitors and the clinical evidence that support the rationale for the use of SGLT2 inhibitors in patients with HF who have T2D. Because these favorable effects presumably occur independent of blood glucose lowering, we also explore the potential use of SGLT2 inhibition in patients without T2D with HF or at risk of HF, such as in patients with coronary artery disease or hypertension. Finally, we provide a detailed overview and summary of ongoing cardiovascular outcome trials with SGLT2 inhibitors.

Indexed as

Sodium-Glucose Transporter 2 InhibitorsBenzhydryl CompoundsClinical Trials as TopicCoronary Artery DiseaseDiabetes Mellitus, Type 2Diabetic CardiomyopathiesFemaleGlucosidesHeart FailureHospitalizationHumansHypertensionMaleRisk FactorsSodium-Glucose Transporter 2Benzhydryl CompoundsempagliflozinGlucosidesSLC5A2 protein, humanSodium-Glucose Transporter 2Sodium-Glucose Transporter 2 Inhibitorsclinical trialheart failuresodium glucose transporter 2

Identifiers

PMID29061576
PMCPMC5846470
OpenAlexW2766617433

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.