Efecto de la dapagliflozina sobre la función microvascular en mujeres con síntomas de enfermedad arterial coronaria (SMILE)

Inclusion Criteria:

• Willing to provide written informed consent.
• Signs and symptoms of suspected ischemia that prompted referral for further evaluation by cardiac catheterization or coronary computed tomography within two years of consent.
• No evidence of obstructive epicardial coronary artery disease (stenosis >50%) of a major epicardial vessel (>3mm) or a fractional flow reserve >0.80 by invasive catheterization or coronary computed tomography. (Participants who have not undergone cardiac catheterization or coronary angiogram within the last 2 years for their clinical care will be screened with computed angiogram of the coronary arteries to confirm eligibility).
• Estimated glomerular filtration rate ≥30ml/min/1.73m2 at enrollment
• For subjects having a history of type 2 diabetes mellitus: approval of diabetes care/prescribing provider

Exclusion Criteria:

• History of non-ischemic cardiomyopathy with left ventricular ejection fraction <40% or hypertrophic cardiomyopathy.
• History of congestive heart failure, severe pulmonary disease, liver disease
• History of Acute coronary syndrome within previous 30 days
• Stroke within the last 180 days or intracranial hemorrhage at any time.
• Severe Valvular disease
• Life expectancy <3 years, due to non-cardiovascular comorbidity.
• Pregnancy or women who are breast-feeding
• Type 1 diabetes mellitus
• History of diabetic ketoacidosis in subjects with Type 2 Diabetes Mellitus
• Symptomatic hypotension or systolic blood pressure <95 mmHg on 2 consecutive measurements
• Active malignancy requiring treatment at the time of visit
• Severe, unstable, or rapidly progressing renal disease at the time of randomization
• History of recurrent urinary tract, bladder, or kidney infections