Sodium-glucose cotransporter 2 inhibitors and death and heart failure in type 2 diabetes

The Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients-Removing Excess Glucose (EMPA-REG OUTCOME) trial demonstrated that one of sodium-glucose cotransporter 2 inhibitors (SGLT2i), empagliflozin, reduced all-cause death, death from cardiovascular causes and hospitalization for heart failure when given in addition to standard care in patients with type 2 diabetes at high cardiovascular risk (1), giving us a big surprise and a question to solve whether this result is a drug effect or a class effect.