A review of potential mechanisms and uses of SGLT2 inhibitors in ischemia-reperfusion phenomena

Core Tip

Core Tip: The antidiabetic drug-class sodium-glucose cotransporter-2 inhibitors (SGLT2i) showed efficacy in decreasing mortality in patients with chronic heart failure, in whom ischemia counts among the first cause. Remarkably, this benefit was observed independently from diabetic status. This feature, yielded from several randomized controlled trials, suggests additional effects from SGLT2i beyond isolated glycemia control. Indeed, previous in-vitro and animal models analyzed altogether suggests the role of the inhibition of the Na⁺/H⁺ exchanger, which holds a pivotal role in ischemia/reperfusion injuries. In this review, we aim to summarize evidence which associate SGLT2i and ischemia/reperfusion injuries, by first listing known mechanisms which portend the latter, and second, hypothesize how the former may interact with these mechanisms.