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Corresponding author at: Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, "Attikon" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GreeceBiomedical Research Foundation of the Academy of Athens, Athens, GreeceCenter for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215, United StatesSection of Endocrinology, VA Boston Healthcare System, Jamaica Plain, MA 02130, United States
The increasing prevalence of metabolic disease, along with cardiometabolic multimorbidity
remains a leading healthcare challenge, despite advances in biomarker discovery and
a broad pharmacological armamentarium [
]. Sodium-glucose cotransporter-2 (SGLT2) inhibitors introduced a paradigm shift in
the management of diabetes. They have been shown to lower glycated hemoglobin, fasting
and postprandial plasma glucose levels, body weight, and blood pressure, while also
offering cardio- and nephroprotection (Fig. 1) [
Differential indication for SGLT-2 inhibitors versus GLP-1 receptor agonists in patients
with established atherosclerotic heart disease or at risk for congestive heart failure.
Cardiorenal protection with SGLT2 inhibitors in patients with diabetes mellitus: from
biomarkers to clinical outcomes in heart failure and diabetic kidney disease.
Fig. 1SGLT2 inhibition impacts a broad range of functions across different organs and systems,
jointly contributing to a multitude of benefits for the cardiovascular system, including
reduced cardiac denervation, cardiac autonomic dysfunction and vaso-vagal syncope
recurrence. (Abbreviations: CKD: chronic kidney disease, NHE: Na+/H+ exchanger, O2:
oxygen, RAAS: renin-angiotensin-aldosterone system).
Differential indication for SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with established atherosclerotic heart disease or at risk for congestive heart failure.
Cardiorenal protection with SGLT2 inhibitors in patients with diabetes mellitus: from biomarkers to clinical outcomes in heart failure and diabetic kidney disease.
SGLT2-inhibitors reduce the cardiac autonomic neuropathy dysfunction and vaso-vagal syncope recurrence in patients with type 2 diabetes mellitus: the SCAN study.
The role of the kidneys in glucose homeostasis in type 2 diabetes: clinical implications and therapeutic significance through sodium glucose co-transporter 2 inhibitors.
Empagliflozin and dapagliflozin reduce ROS generation and restore NO bioavailability in tumor necrosis factor alpha-stimulated human coronary arterial endothelial cells.
Canagliflozin inhibits interleukin-1beta-stimulated cytokine and chemokine secretion in vascular endothelial cells by AMP-activated protein kinase-dependent and -independent mechanisms.
Hyperglycaemic impairment of PAR2-mediated vasodilation: prevention by inhibition of aortic endothelial sodium-glucose-co-Transporter-2 and minimizing oxidative stress.
Effects of the selective sodium-glucose cotransporter 2 inhibitor empagliflozin on vascular function and central hemodynamics in patients with type 2 diabetes mellitus.
Effects of SGLT-2 inhibitors on vascular endothelial function and arterial stiffness in subjects with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.
Minimizing hyperglycemia-induced vascular endothelial dysfunction by inhibiting endothelial sodium-glucose cotransporter 2 and attenuating oxidative stress: implications for treating individuals with type 2 diabetes.
Direct cardiac actions of sodium-glucose cotransporter 2 inhibition improve mitochondrial function and attenuate oxidative stress in pressure overload-induced heart failure.
