McMurray JJV, Solomon SD, Inzucchi SE, et al. - Given a reduced risk of first hospitalization for heart failure among patients with type 2 diabetes in correlation with receipt of inhibitors of sodium–glucose cotransporter 2 (SGLT2), researchers investigated how SGLT2 inhibitors influence patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes. They conducted phase 3, placebo-controlled trial, randomizing 4,744 patients with New York Heart Association class II, III, or IV heart failure and an ejection fraction of 40% or less to either dapagliflozin (at a dose of 10 mg once daily) or placebo, in addition to recommended therapy. Over a median of 18.2 months, worsening heart failure (hospitalization or an urgent visit resulting in intravenous therapy for heart failure) or cardiovascular death was reported in 386 of 2,373 patients (16.3%) in the dapagliflozin group and in 502 of 2,371 patients (21.2%) in the placebo group. Among patients with heart failure and a reduced ejection fraction, those who received dapagliflozin showed a lower risk of worsening heart failure or death from cardiovascular causes than those who received a placebo. This was observed regardless of the presence or absence of diabetes.