Background: Diabetes mellitus is a major cardiovascular risk factor. Despite the vast pharmaceutical
armamentarium, current therapeutic options for the treatment of type 2 diabetes mellitus were unable to provide
consistent cardiovascular benefits, apart for metformin. The newest antidiabetic class of drugs, the SGLT-2 inhibitors,
seem to provide significant survival benefits. The aim of this review is to present available data that will
clarify whether SGLT-2 inhibitors could precipitate in reducing cardiovascular risk in diabetes mellitus.
Methods: A comprehensive literature search was performed to identify available data from clinical and experimental
studies evaluating the impact of SGLT-2 inhibitors in cardiovascular risk factors and outcomes.
Results: Along with a mild antihyperglycemic effect, SGLT-2 inhibitors seem to possess multi-dimensional properties,
affecting positively several recognized cardiovascular risk factors such as increased blood pressure, arterial
stiffness, body weight and dyslipidemia. Furthermore, preliminary data point towards additional benefits, including
reduction of albuminuria in diabetic nephropathy, and reduction of oxidative markers and fatty liver disease in
experimental models. The efficacy and safety profile of empagliflozin, an SGLT-2 inhibitor, was evaluated in the
EMPA-REG outcome study, and the results were quite impressive. Further credence comes from the analysis of
pooled data of SGLT-2 inhibitors trials that have shown similar results.
Conclusion: SGLT-2 Inhibitors seem to be related with ameliorating effects on multiple cardiovascular risk factors.
The first data from the EMPA-REG outcome study are indeed very promising. Several ongoing cardiovascular
studies with this novel class of drugs will shed light and enforce or question current enthusiasm.