CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 2, March/April 2022 AFRICA 73 2019; 9(4): 189. 52. Dinh W, Füth R, Nickl W, Krahn T, Ellinghaus P, Scheffold T, et al. Elevated plasma levels of TNF-alpha and interleukin-6 in patients with diastolic dysfunction and glucose metabolism disorders. Cardiovasc Diabetol 2009; 8: 58. 53. Jurisic Z, Martinovic-Kaliterna D, Marasovic-Krstulovic D, Perkovic D, Tandara L, Salamunic I, et al. Relationship between interleukin-6 and cardiac involvement in systemic sclerosis. Rheumatology (Oxford) 2013; 52(7): 1298–1302. 54. Yan AT, Yan RT, Cushman M, Redheuil A, Tracy RP, Arnett DK, et al. Relationship of interleukin-6 with regional and global left-ventricular function in asymptomatic individuals without clinical cardiovascular disease: insights from the Multi-Ethnic Study of Atherosclerosis. Eur Heart J 2010; 31(7): 875–882. SGLT2 inhibitors in preserved ejection fraction heart failure: meta-analysis Sodium-glucose co-transporter-2 (SGLT2) inhibitors, beneficial in reduced ejection fraction heart failure, can also treat preserved ejection fraction, found a meta-analysis by the University of East Anglia (UEA) in the European Journal of Preventive Cardiology. Lead researcher Prof Vass Vassiliou, from UEA’s Norwich Medical School and an honorary consultant cardiologist at the Norfolk and Norwich University Hospital, said: ‘Heart failure affects about one million people in the UK. ‘There are two types. Heart failure with a reduction in ejection fraction happens when the heart is unable to pump blood round the body due to a mechanical issue. And heart failure with preserved ejection fraction happens when, despite the heart pumping out blood well, it is not sufficient to provide oxygen to all the parts of the body. Patients are equally split between the two types of heart failure. ‘For many years there was not a single medicine that could improve the outcome in patients with the second type of heart failure, those with preserved ejection fraction. This type of heart failure had puzzled doctors, as every medicine tested showed no benefit. ‘One class of heart medication, called SGLT2 inhibitors, was initially used for patients with diabetes. However, it was noticed that it also helped patients who had heart failure. ‘Previous studies had shown this medication would be beneficial in heart failure with reduced ejection fraction. But we found that it can also help heart failure patients with preserved ejection fraction.’ SGLT2 inhibitors are more commonly known under their trade names: Forxiga (dapagliflozin), Invokana (canagliflozin), and Jardiance (empagliflozin). The research team undertook a meta-analysis of all studies published in the field and brought together data from almost 10 000 patients. They used statistical modelling to show the specific effect of these medicines. Vassiliou said: ‘We found that patients taking SGLT2 inhibitors were 22% less likely to die from heart-related causes or be hospitalised for heart failure exacerbation than those taking placebo. ‘This is very important because this is the first medication that can provide a benefit to this previously untreatable group of patients, in terms of heart-related deaths or hospitalisation … it will revolutionise the treatment offered to heart failure patients’, he added. The study was led by researchers at UEA in collaboration with the Norfolk and Norwich University Hospital, Imperial College London and Imperial College NHS Trust, and Cambridge University Hospitals. Source: MedicalBrief 2022
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