The effect of sodium-glucose cotransporter-2 inhibitors on cardiovascular biomarkers and left ventricular function in patients with type 2 diabetes and concomitant cardiovascular disease.

INTRODUCTION

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to assess the effects of SGLT2i therapy on heart failure (HF)-related biomarkers - galectin‑3 (GAL‑3) and N-terminal pro-B-type natriuretic peptide (NT‑proBNP) - as well as on echocardiographic parameters of cardiac function in patients with T2DM and established cardiovascular disease (CVD).

MATERIAL AND

METHODS

This prospective study included 61 patients with T2DM, all naïve to SGLT2i and with documented CVD. Patients were initiated on dapagliflozin or empagliflozin and followed for a minimum of 6 months (mean follow-up: 9 months). Baseline and post-treatment levels of GAL‑3 and NT‑proBNP were measured. Echocardiographic evaluation included left ventricular ejection fraction (LVEF) and diastolic function parameters.

RESULTS

Following treatment, a significant reduction in NT‑proBNP concentrations was observed (p = 0.002), along with reductions in GAL‑3 levels, body weight, and body mass index (BMI). LVEF significantly improved, with concomitant reductions in interventricular septum (IVS) and posterior wall thickness. NT‑proBNP concentrations were higher in patients with atrial fibrillation, whereas GAL‑3 levels were lower in those with BMI ≥ 30 kg/m². A significant inverse correlation between estimated glomerular filtration rate (eGFR) and NT‑proBNP was noted. No major adverse cardiovascular events occurred, and no patient required intensification of HF therapy. Two patients discontinued treatment due to urogenital tract infections.

CONCLUSIONS

In patients with T2DM and established CVD, SGLT2i therapy was associated with significant improvements in left ventricular function and reductions in HF-related biomarkers, supporting the cardioprotective and nephroprotective effects of this drug class.