A SGLT2 inhibitor is prescribed for a type 2 diabetic with established cardiovascular disease. Besides glycaemic control, which additional benefit has been demonstrated in large cardiovascular outcome trials for this drug class?

• A Reduction in myocardial infarction rates by >30%
• B Prevention of new-onset atrial fibrillation
• C Significant reduction in hospitalisation for heart failure ✓
• D Regression of established atherosclerotic plaques

Explanation

SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin) have demonstrated consistent, robust reduction in hospitalisation for heart failure with reduced ejection fraction in EMPA-REG OUTCOME, CANVAS, and DAPA-HF trials. The mechanism is likely multifactorial, including natriuresis/osmotic diuresis, reduced preload/afterload, and possible direct myocardial metabolic effects (ketone utilisation). This benefit is now a primary indication independent of diabetes status.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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