1. Sodium-Glucose Cotransporter 2 Inhibitors and Mycotic Genital or Urinary Tract Infections in Heart Failure.
- Author
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Duvalyan, Angela, La Hoz, Ricardo M., McGuire, Darren K., and Drazner, Mark H.
- Abstract
• Although sodium-glucose cotransporter-2 inhibitors (SGLT2is) increase the risk of mycotic genital infections (MGIs) and possibly urinary tract infections (UTIs), their cardiovascular benefits in patients with heart failure far outweigh those risks. • Patients receiving SGLT2is should be educated about steps to reduce risks of MGI/UTIs. • For MGI/UTI concerns, few conditions (current or recurrent MGI/UTIs, adult polycystic kidney disease) preclude starting SGLT2is. • If an uncomplicated MGI/UTI occurs, reflexive discontinuation of SGLT2is is not necessary. • If SGLT2is are stopped due to MGI/UTIs, plans to reinitiate them should be made. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) improve clinical outcomes in persons with heart failure (HF). This class of agents has been consistently associated with an increased risk of mycotic genital infections (MGIs), and in some, but not all trials, urinary tract infections (UTIs). Other medications widely used for cardiac conditions do not cause MGIs and UTIs, so cardiologists and their supporting teams will be encountering clinical questions that they previously did not have to address. This review provides clinicians with practical recommendations about SGLT2i use in individuals with HF as related to the associated MGI and possible UTI risks. Overall, given the benefit of SGLT2is in clinical outcomes, the threshold for not initiating or discontinuing SGLT2is due to concerns for MGIs or UTIs should be high for persons with HF. Likewise, when SGLT2is are discontinued for such concerns, the threshold for reinitiation should be low. [Display omitted]. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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