Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
Academic Level (Author 3)
Medical Student
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background: Heart failure with preserved ejection fraction (HFpEF) presents significant clinical and therapeutic challenges. This is especially true when patients have comorbidities such as type 2 diabetes (T2D) and chronic kidney disease (CKD). Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have shown efficacy in managing HFpEF by reducing hospitalizations, improving cardiovascular outcomes, an enhancing quality of life. This systematic review synthesized evidence from recent studies to evaluate the impact of SGLT2 is and adjunct therapies in management of HFpEF.
Methods: We systematically reviewed abstracts from PubMed, ScienceDirect, and Cochrane Library that investigated the efficacy of SGLT2is (dapagliflozin, empagliflozin, tofogliflozin) in patients with HFpEF. From 75 original articles with strict inclusion criteria 25 original research articles were identified. We focused on hospitalizations for heart failure (HHF), cardiovascular (CV) mortality, quality of life metrics, and biomarker changes.
Results: Dapagliflozin and empagliflozin significantly reduced HHF and CV mortality in HFpEF patients. In DELIVER and EMPEROR-Preserved trails, empagliflozin was shown to reduce the composite outcomes of HHF and CV mortality with hazard ratios of 0.79 and 0.77 respectively. Dapagliflozin reduced NT-proBNP levels, improved ejection fraction, and led to weight loss in HFpEF patients. Semaglutide was shown to reduce HF-related events and CV mortality in a T2D and CKD population. This was with hazard ratios of 0.73 for composite and isolated HF events. SGLT2is improved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores and dapagliflozin showed the largest gains in HFpEF patients that had a high BMI. Empagliflozin improved frailty indices and quality of life measures over the 12 to 52 weeks of treatment. Lokelma allowed for up-titration of the renin-angiotensin-aldosterone system inhibitors in hyperkalemic HF patients with CKD. Empagliflozin showed reductions in the risk on anthracycline-induced cardiotoxicity in cancer patients with high risks of HF. SGLT2is demonstrated consistent efficacy across geographic regions and demographic variations. North America showed higher baseline event rates, but similar relative risk reduction.
Conclusion: SGLT2is, especially dapagliflozin and empagliflozin, reduce HHF, CV mortality, and enhance quality of life in HFpEF patients. Adjunct therapies like Lokelma and semaglutide allow for targeted benefits in hyperkalemia and T2D-related HFpEF cases. Future research should focus on refining therapeutic strategies and including combining SGLT2is with novel agents. This would allow for outcomes to be maximized in diverse patient populations.
Recommended Citation
Shaju, Ronald A.; Gutierrez, Yolanda V.; Sepulveda, Alyssa L.; and Cruz, Melissa M., "Comparative Impact of SGLT2 Inhibitors and Emerging Therapies on Heart Failure With Preserved Ejection Fraction" (2025). Research Symposium. 137.
https://scholarworks.utrgv.edu/somrs/2025/posters/137
Included in
Comparative Impact of SGLT2 Inhibitors and Emerging Therapies on Heart Failure With Preserved Ejection Fraction
Background: Heart failure with preserved ejection fraction (HFpEF) presents significant clinical and therapeutic challenges. This is especially true when patients have comorbidities such as type 2 diabetes (T2D) and chronic kidney disease (CKD). Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have shown efficacy in managing HFpEF by reducing hospitalizations, improving cardiovascular outcomes, an enhancing quality of life. This systematic review synthesized evidence from recent studies to evaluate the impact of SGLT2 is and adjunct therapies in management of HFpEF.
Methods: We systematically reviewed abstracts from PubMed, ScienceDirect, and Cochrane Library that investigated the efficacy of SGLT2is (dapagliflozin, empagliflozin, tofogliflozin) in patients with HFpEF. From 75 original articles with strict inclusion criteria 25 original research articles were identified. We focused on hospitalizations for heart failure (HHF), cardiovascular (CV) mortality, quality of life metrics, and biomarker changes.
Results: Dapagliflozin and empagliflozin significantly reduced HHF and CV mortality in HFpEF patients. In DELIVER and EMPEROR-Preserved trails, empagliflozin was shown to reduce the composite outcomes of HHF and CV mortality with hazard ratios of 0.79 and 0.77 respectively. Dapagliflozin reduced NT-proBNP levels, improved ejection fraction, and led to weight loss in HFpEF patients. Semaglutide was shown to reduce HF-related events and CV mortality in a T2D and CKD population. This was with hazard ratios of 0.73 for composite and isolated HF events. SGLT2is improved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores and dapagliflozin showed the largest gains in HFpEF patients that had a high BMI. Empagliflozin improved frailty indices and quality of life measures over the 12 to 52 weeks of treatment. Lokelma allowed for up-titration of the renin-angiotensin-aldosterone system inhibitors in hyperkalemic HF patients with CKD. Empagliflozin showed reductions in the risk on anthracycline-induced cardiotoxicity in cancer patients with high risks of HF. SGLT2is demonstrated consistent efficacy across geographic regions and demographic variations. North America showed higher baseline event rates, but similar relative risk reduction.
Conclusion: SGLT2is, especially dapagliflozin and empagliflozin, reduce HHF, CV mortality, and enhance quality of life in HFpEF patients. Adjunct therapies like Lokelma and semaglutide allow for targeted benefits in hyperkalemia and T2D-related HFpEF cases. Future research should focus on refining therapeutic strategies and including combining SGLT2is with novel agents. This would allow for outcomes to be maximized in diverse patient populations.
