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In a 2019 study of 4744 patients with NYHA class II, III, IV heart failure and ejection fraction of less 40%, dapagliflozin (a sodium-glucose co-transporter 2 inhibitor) reduced the cumulative incidence of worsening heart failure or cardiovascular death.
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In addition to their cardioprotective effects, the sodiumglucose linked transporter (SGLT) inhibitors, eg, canagliflozin and empagliflozin, slow progression of early diabetic nephropathy. Use of these agents may require reduction in diuretic dosing in those patients requiring natriuresis, and they should not be used in advanced chronic kidney disease.