Utility of SGLT2 Inhibitors in Patients with Chronic Heart Failure with Diabetes Mellitus

Introduction: Efficacy of SGLT2 inhibitors on cardiovascular death has been reported by the EMPA-REG study. Meanwhile, SGLT2 inhibitors have been proposed for recommendations on excessive dehydration and use in Flail cases. We report on the usefulness and side effects of Canagliflozin administered to 22 patients with heart failure with diabetes mellitus who has mild renal dysfunction and can not tolerate the increase in diuretic. Methods and Results: Twenty-two cases (16 males, average 77.8 ± 11.2 years) were administered Canagliflozin 100 mg every day for an average of 6 months. NYHA (2.5–2.1), body weight (56.6–55.1 kg), systolic blood pressure (131.6–128.9 mmHg), CTR in chest XP (59.7–56.6%), NTproBNP (881–563 pg/ml), creatinine (1.77–1.63 mg/dl) were significant improved. On the other hand, ejection fraction (EF) with echocardiography was not improved before and after treatment (45.3–42.2%), and extended disturbance improved (E/e', 12.43–8.79). There was also no rise in the heart rate frequently seen with diuretics. (81.2–78.4/min) There was no progression of dehydrated or flailed fears. Conclusion: In this study, the usefulness of SGLT2 inhibitor for heart failure patients with diabetes mellitus was suggested. In addition to the dose reduction of diuretic drugs in some of the cases, heart failure has improved despite the flatness of kidney function. Also, elderly people were included, suggesting that side effects could be minimized if used under careful management.