Role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in heart failure with reduced and preserved ejection fraction

Heart failure (HF) is a disease with a constantly increasing prevalence, associated with a high risk of comorbidity and cardiovascular and all-cause mortality. Recent scientific evidence has allowed us to identify 3 phenotypes of HF associated with different etiology, cardiovascular (CV) risk and clinical characteristics of the patient. A consolidated therapy for HF with reduced ejection fraction has consolidated over the years, while the evidence associated with HF with moderately reduced and preserved ejection fraction is still uncertain. However, recent studies have shown a reduction in the risk of CV mortality and hospitalization for HF in patients treated with sodium/glucose cotransporter 2 (SGLT2) inhibitors. The aim of the review is to characterize the different clinical phenotypes of patients affected by HF and to summarize the scientific evidence underlying the use of SGLT2 in clinical practice and the current international recommendations for the use of these drugs.