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SGLT2 Inhibitors in Heart Failure: Clinical Case Scenarios

M3 India Newsdesk Apr 18, 2024

This article explains the role of SGLT2 in treating heart failure, its dosages and possible side effects. It also includes questions related to the case study that is discussed in this article.

SGLT2 inhibitors in the treatment of heart failure

Below are the points to consider while using SGLT2 inhibitors in the treatment of heart failure with reduced ejection fraction: 

  1. Identify suitable patients to start using SGLT2 inhibitors.
  2. Examine obstacles to the start of SGLT2.
  3. Create a plan to implement and oversee SGLT2 in a patient with HFrEF.
  4. Identify SGLT2 inhibitors that heart failure patients may take.
  5. List the essential laboratory parameters to evaluate before starting an SGLT2 inhibitor.
  6. Carry out a strategy to overcome SGLT2 inhibitor pricing obstacles.

Heart failure with reduced ejection fraction( HFrEF)

Guideline-directed medical therapy (GDMT)

The case

A 63-year-old female with a history of coronary artery disease (CAD), heart failure with reduced ejection fraction (HFrEF), and anxiety. She presents to her primary care physician's (PCP) office for her annual visit.

Home medications Vitals and pertinent labs

Aspirin 75 mg daily

Blood pressure (BP): 112/72 mm Hg

Atorvastatin 80 mg daily

HR: 74 beats per minute (bpm)

Metoprolol succinate 50 mg daily

eGFR: 50 mL/min/1.73 m2

Cardace 10 mg daily

Serum creatinine: 1.4 mg/dL(baseline 1.5)

Spironolactone 25 mg daily

Sodium: 136 mEq/L

Furosemide 40 mg daily

Potassium: 4.2 mEq/L

Sertraline 50 mg daily


1. What medication regimen change could optimise the patient's heart failure care?

2. What medication regimen change could optimise the patient's heart failure care?

3. What type of monitoring is required for the patient after the medication change?

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