Abstract

The sodium-glucose cotransporter 2 (SGLT2) inhibitors (dapaglifozin and empaglifozin) have recently established to reduce the risk of cardiovascular death or worsening heart failure (HF) in patients with chronic HF. As heart failure is the burden in hospitalization, this disease is associated with high mortality, mobidity, and decreased quality of life, especially older age with acute heart failure (AHF). Two cornerstones of therapies in AHF are decongestive therapy and optimizing early initiation of chronic heart failure treatment. In several studies, empaglifozin seems to be beneficial in improving clinical outcome of patients with AHF. However, SGLT2 inibitors are not licensed in this setting. The close interaction between type 2 diabetes mellitus (T2DM) and AHF is providing the intriguing mechanisms of SGLT2 inhibitors for improving diuresis and natriuresis without interfering renin-angiotensin-aldosteron system. There are various trials have been ongoing for answering this big question.