Résumé
Originally developed for the treatment of type 2 diabetes, gliflozines have shown unexpected cardiac benefits in clinical trials. Indeed, their mechanism of action is particularly interesting.On the one hand, they cause glycosuria allowing a decrease in blood sugar, regardless of insulin production, and on the other hand they induce natriuresis reducing the conditions of favorable left ventricular load in a patient with heart failure.In cardiovascular safety trials, the tolerance profile was reassuring. Then, clinical studies have highlighted major cardiovascular benefits such as a 30% reduction in the risk of hospitalization for heart failure, a significant decrease in cardiovascular deaths, whether patients have diabetes or not, and a decrease in overall mortality. Moreover, these effects have the advantage of appearing very soon after their introduction.This has led to changes in the recommendations of learned societies. To date, gliflozineshave been added to the therapeutic strategies of type 2 diabetes. It is recommended tocombine them with metformin on the first line when a diabetic patient has heart failure.