Expanding the possibilities of using sodium-glucose cotransporter 2 inhibitors in patients with heart failure.

OBJECTIVE: Aim: To study the potential mechanisms of the beneficial cardiovascular effects of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, the possibilities of improving the treatment and prognosis of patients with acute heart failure (HF) during their use. PATIENTS AND METHODS: Materials and Methods: The data analysis of literary sources has been conducted regarding the results of existing studies evaluating the clinical benefit and safety of SGLT-2 inhibitors in patients with acute heart failure. CONCLUSION: Conclusions: The peculiarities of the pharmacological action of SGLT-2 inhibitors and the obtained research results expand the possibilities of using this group of drugs, demonstrating encouraging prospects in improving the prognosis of patients hospitalized with acute heart failure.

CLINICAL EFFECTIVENESS OF EMPAGLIFLOZIN IN PATIENTS WITH HEART FAILURE.

OBJECTIVE: The aim: To study the possibilities of increasing the effectiveness of treatment and improving the prognosis of patients with various phenotypes of heart failure when using empagliflozin. PATIENTS AND METHODS: Materials and methods: The analysis of the data regarding the results of existing studies evaluating the clinical benefit and safety of empagliflozin in patients with various phenotypes of heart failure has been conducted. CONCLUSION: Conclusions: In the EMPA-REG OUTCOME study, empagliflozin has demonstrated the ability to improve cardiorenal outcomes and reduce the risk of hospitalization for heart failure in patients with diabetes. The results of the studies (EMPEROR-Preserved, EMPEROR-Reduced, EMPULSE) have shown the clinical advantages of empagliflozin over traditional heart failure therapy, manifested by a reduction in mortality and the number of hospitalizations for heart failure, as well as improvement in quality of life indicators. The clinical benefits of using empagliflozin were observed in patients with chronic heart failure with different left ventricular ejection fraction, as well as in patients with acute heart failure. Empagliflozin is a sodium-glucose co-transporter 2 inhibitor with a convincing evidence base for the treatment of all categories of patients with chronic heart failure, regardless of diabetes status. The results of the conducted studies indicate the unconditional benefit of early initiation of empagliflozin therapy in patients with both chronic and acute heart failure after the stabilization of their condition.

LOOP DIURETICS IN HEART FAILURE: EVIDENCE-BASED CHOICE.

OBJECTIVE: The aim: Of the article is to conduct a comparative evaluation of the effectiveness of torasemide and furosemide in patients with heart failure. PATIENTS AND METHODS: Materials and methods: Analysis of the existing clinical trials and meta-analyzes that combine the results of the completed studies aimed at the investigation of comparative efficacy of furosemide and torasemide in patients with heart failure (НF). CONCLUSION: Conclusions: There is enough convincing evidence to speak about the advantages of torasemide over furosemide both in terms of its pharmacological properties and taking into account the reduction of hospitalizations, functional progress and improvement in the quality of life of patients with НF. The safety profile of torasemide is more favorable, as it is associated with a reduced risk of hypokalemia compared to furosemide. The abovementioned facts favor the use of torasemide in patients with symptomatic НF, as well as the transition from furosemide to torasemide in patients with edema caused by НF, which remain uncontrolled despite receiving optimal doses of furosemide.

Priorities of anti-hyperglycaemic drug therapy in patients with type 2 diabetes and heart failure.

OBJECTIVE: The aim is to explore the possibilities of improving the effectiveness in preventing cardiovascular diseases and heart failure using sodium-glucose co-transporter 2 inhibitors. PATIENTS AND METHODS: Materials and methods: The analysis of the existing clinical and experimental data on the effect of sodium-glucose co-transporter 2 (SGLT-2) inhibitors on the cardiovascular system, the condition of kidneys, cardiovascular risk factors. RESULTS: Review: SGLT-2 inhibitors are the first class of glucose-lowering agents in large-scale studies (EMPA-REG OUTCOME, CANVAS, CVD-REAL, CVD-REAL2) which have demonstrated the ability to improve cardiorenal outcomes and reduce the risk of hospitalization with heart failure in patients with diabetes. In addition to hypoglycaemic action, SGLT-2 inhibitors show a number of pleiotropic effects, which are potentially capable of reducing cardiovascular risk: diuretic effect, decrease in: blood pressure, arterial wall stiffness, waist and body weight, expression of albuminuria, etc. The use of drugs of this class opens great prospects not only in terms of glycaemic control, but also in the prevention of cardiovascular complications of diabetes. CONCLUSION: Conclusions: 1. When choosing glucose-lowering agents in patients with type 2 diabetes, it is necessary to take into account their impact on the risk of development and the course of heart failure. 2. SGLT-2 inhibitors ought to be considered as a preferred method of treatment for type 2 diabetes in patients with heart failure or with a risk of heart failure that meets the latest recommendations of the European and American Diabetes Association.