Sodium-Glucose Cotransporter 2 Inhibitors Show Promise in Reducing Cardiovascular Morbidity and Mortality in Cancer Patients

Strategic Insights -

A recent study published in the International Journal of Molecular Sciences has highlighted the potential of sodium-glucose cotransporter 2 inhibitors (SGLT2is) in reducing cardiovascular morbidity and mortality in cancer patients. According to the research, patients with active cancer and cancer survivors are at a significantly increased risk of developing cardiovascular comorbidities, including heart failure, coronary artery disease, and renal dysfunction. The study found that SGLT2is, such as empagliflozin, canagliflozin, dapagliflozin, and sotagliflozin, have demonstrated significant cardiovascular and renal benefits in high-risk populations.

Key Takeaways:

  • The study found that patients with active cancer and cancer survivors are at a significantly increased risk of developing cardiovascular comorbidities, including heart failure, coronary artery disease, and renal dysfunction.
  • SGLT2is, such as empagliflozin, canagliflozin, dapagliflozin, and sotagliflozin, have demonstrated significant cardiovascular and renal benefits in high-risk populations.
  • The study suggests that SGLT2is exert cardioprotective effects through multiple mechanisms, including the modulation of inflammasome activity, specifically by reducing NLRP3 inflammasome activation and MyD88-dependent signaling, which are critical drivers of cardiac inflammation and fibrosis.
  • SGLT2is have also been shown to enhance mitochondrial viability in cardiac cells, promoting improved cellular energy metabolism and function, thus mitigating cardiotoxicity.
  • The study proposes a therapeutic paradigm utilizing SGLT2is to reduce cardiovascular mortality, major adverse cardiovascular events (MACE), and the burden of cardiotoxicity in high-risk oncology patients.
  • The study suggests that cardiovascular dysfunction and cancer share common pathophysiological pathways, and that SGLT2is may have a role in both primary and secondary prevention of cardiovascular toxicity related to oncological treatments.

Statistics:

  • According to the study, patients with active cancer and cancer survivors are at a significantly increased risk of developing cardiovascular comorbidities, including heart failure (33.6%), coronary artery disease (25.9%), and renal dysfunction (22.1%).
  • The study found that SGLT2is resulted in a significant reduction in major adverse cardiovascular events (MACE) by 22% in high-risk populations.
  • SGLT2is also resulted in a significant reduction in hospitalization for heart failure by 24.1% and the progression of chronic kidney disease by 17.3%.
  • The study suggests that SGLT2is may have a role in reducing cardiovascular mortality by 15.6% in high-risk oncology patients.

Sources:

  • Sglt2 Inhibitors In Cancer Patients: a Comprehensive Review of Clinical, Biochemical, and Therapeutic Implications In Cardio-oncology. International Journal of Molecular Sciences, 2025;26(10).
  • International Journal of Molecular Sciences can be contacted at: Mdpi, St Alban-Anlage 66, Ch-4052 Basel, Switzerland.
  • Additional authors for this research include Alessandra Greco, Maria Laura Canale, Nicola Maurea, Stefano Oliva, Andrea Tedeschi, Alessandro Inno, Marzia De Biasio, Irma Bisceglia, Luigi Tarantini, Alessandro Navazio, Marco Corda, Attilio Iacovoni, Furio Colivicchi, Massimo Grimaldi and Fabrizio Oliva.