Impact of a Short-term Treatment With Canagliflozin (Canacardia-HF) (Canacardia)

Inclusion Criteria:

• HbA1c 7.5 -10.5%;
• LVEF < 40%;
• NYHA class 2 or 3;
• NT pro-BNP level > 600 pg/mL;
• Being on a stable-dose metformin therapy max 2500 mg/day or other hypoglycemic therapy and RAAS-blocking agents for at least 8 weeks;
• Being on optimal and stable-doses of heart failure medication including diuretics for at least 4 weeks;

Exclusion Criteria:

• age <18 yo;
• NYHA class 4;
• Treatment with a fibrate or thiazolidinedione;
• Unstable or advanced renal failure;
• Unstable or new medical or surgical condition within the past 3 months;
• Heart failure caused by active inflammatory condition such as sarcoidosis or any form of myocarditis;
• History of diabetic ketoacidosis;
• Not on a stable regimen for at least 8 weeks before the screening visit;
• Female of child-bearing potential who is pregnant, breast feeding or intends to become pregnant or pre-menopausal female with a positive serum pregnancy test at the time of enrollment;
• Patients post bariatric surgery, or on weight loss medication;
• Contraindications to metformin, including allergy or intolerance;
• Hospitalization for heart failure within the 60 days prior to enrollment;
• Admission for an acute coronary syndrome, percutaneous coronary intervention, or cardiac surgery within the 60 days prior to enrollment;
• Planned cardiovascular revascularization (percutaneous intervention or surgical) or major cardiac surgery (coronary artery bypass grafting, valve replacement, ventricular assist device, cardiac transplantation, or any other surgery requiring thoracotomy) within the 90 days after enrollment;
• Patients who are volume depleted based upon physical examination at the time of enrollment;
• Chronic disabling illness;
• History of substance abuse.