SGLT2 inhibitors, a type of antidiabetic medication, has demonstrated significant advancements in improving outcomes for individuals with type 2 diabetes (T2D) who face heightened risks of cardiovascular issues. Clinical trials have extensively evaluated the safety and effectiveness of SGLT2 inhibitors in patients with diabetes, particularly those with established vascular disease, Cardiovascular risk factors, renal insufficiency, and heart failure, irrespective of T2D. Although the detailed mechanisms underlying these cardiovascular benefits remain incompletely understood, it is suggested that SGLT2 inhibitors may enhance cardiac function through favorable effects on blood pressure, diuresis, and natriuresis.1,2 Specific SGLT2 inhibitors, including empagliflozin, canagliflozin, and dapagliflozin, have been investigated in randomized clinical trials such as EMPA-REG OUTCOME, CANVAS, and DECLARE-TIMI 58, demonstrating their positive effects on heart health.1,3, 4, 5 For instance, the EMPA-REG OUTCOME trial showed a reduction in major cardiovascular and renal outcomes, including cardiovascular death and heart failure hospitalizations, in individuals with T2DM at high cardiovascular risk treated with empagliflozin .6 Subsequent trials with other SGLT2 inhibitors have corroborated these findings 7, 8, 9 sparking interest in further exploring the cardiovascular advantages of SGLT2 inhibitors.

The recent interest in the cardiovascular benefits of SGLT2 inhibitors suggests potential implications for their influence on the inflammatory response, which may contribute to mitigating adverse cardiac remodeling and improving cardiovascular outcomes. Studies involving mice with SGLT knockdown have demonstrated reduced inflammation, oxidative stress, myocardial necrosis, and infarct size following ischemia-reperfusion injury .10 Additionally, the SGLT2 inhibitor AMI Protect registry indicated significantly lower inflammatory parameters in diabetic patients following acute myocardial infarction (AMI) . 11,12 Moreover, the lower incidence of hyperglycemic events and reductions in inflammatory markers such as CRP and pro-inflammatory cytokines in patients on SGLT2 inhibitor therapy suggest a direct anti-inflammatory effect beyond glucose-lowering properties. While the precise mechanisms remain unclear, it is speculated that SGLT2 inhibitors may modulate inflammatory signaling pathways within cardiac cells. Despite growing clinical evidence supporting the effectiveness of SGLT2 inhibitors in improving cardiovascular outcomes through diverse pathways, the precise mechanisms by which these inhibitors influence inflammation and exert anti-inflammatory effects in heart cells remain inadequately explored. To address this knowledge gap, we conducted a comprehensive literature search on PubMed, focusing specifically on the influence of SGLT2 inhibitors on different cardiac cells and their role in inhibiting inflammation and promoting anti-inflammatory processes. This investigation unveils promising avenues for further research and discoveries, laying a crucial foundation for advancing the treatment of heart disease in individuals with and without diabetes.