Does canagliflozin decrease natriuretic peptide levels in patients with diabetes and heart failure?

Abstract

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have recently been introduced as an oral antidiabetic therapy; proving to be safe and showing a reduction in the risk of cardiovascular events in patients with type 2 diabetes (T2D) [1–3], especially in terms of hospitalization for heart failure (HF). In a recent study, DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure) trial [4], in which patients with chronic HF and reduced ejection fraction with and without diabetes were included; dapagliflozin demonstrated a reduction in the composite primary outcome (hospitalization or an urgent visit resulting in intravenous therapy for HF and death from cardiovascular causes) and death from any cause. Several mechanisms have been proposed to explain the benefit of SGLT2i, such as improvement in loading conditions, cardiac metabolism and bioenergetics, inhibition of myocardial Na+/H+ exchange, reduction of cardiac fibrosis or a alteration in adipokines and vascular function