Sodium–glucose cotransporter 2 inhibitors (SGLT2i), a new drug class initially designed and approved for treatment of diabetes mellitus, have been shown to exert pleiotropic metabolic and direct cardioprotective and nephroprotective effects that extend beyond their glucose-lowering action. These properties prompted their use in two frequently intertwined conditions, heart failure and chronic kidney disease. Their unique mechanism of action makes SGLT2i an attractive option also to lower the rate of cardiac events and improve overall survival of oncological patients with preexisting cardiovascular risk and/or candidate to receive cardiotoxic therapies. This review will cover biological foundations and clinical evidence for SGLT2i modulating myocardial function and metabolism, with a focus on their possible use as cardioprotective agents in the cardio-oncology settings. Furthermore, we will explore recently emerged SGLT2i effects on hematopoiesis and immune system, carrying the potential of attenuating tumor growth and chemotherapy-induced cytopenias.

钠-葡萄糖协同转运蛋白 2 抑制剂 (SGLT2i) 是一类最初设计并批准用于治疗糖尿病的新药物，已被证明可以发挥多效性代谢作用以及直接的心脏保护和肾保护作用，其作用超出了降糖作用。这些特性促使它们用于治疗两种经常相互交织的疾病：心力衰竭和慢性肾病。 SGLT2i 独特的作用机制使 SGLT2i 成为一种有吸引力的选择，可以降低心脏事件的发生率并提高具有心血管风险的肿瘤患者和/或接受心脏毒性治疗的候选者的总体生存率。本综述将涵盖 SGLT2i 调节心肌功能和代谢的生物学基础和临床证据，重点是它们在心脏肿瘤学环境中作为心脏保护剂的可能用途。此外，我们将探索最近出现的 SGLT2i 对造血和免疫系统的影响，其具有减弱肿瘤生长和化疗引起的血细胞减少的潜力。