Overview
The aim of this study is to investigate the hypothesis that treatment with empagliflozin may have an impact on red blood cell 2,3-biphosphoglycerate levels affecting tissue oxygen supply and thus mediating part of the cardio- and reno- protective effect of SGLT-2 inhibitors.
Eligibility
Inclusion Criteria:
Patients>18 year-old and at least one of the following
- Type 2 Diabetes Mellitus and HbA1c: 6.5-9.0% or HbA1c <6.5% and history of Coronary Artery Disease or Stroke not treated with GLP-1RA
- Heart Failure defined as Ejection Fraction<40% or NT-proBNP>300pg/ml or Atrial fibrillation and NT-proBNP>900pg/ml
- Chronic Kidney Disease defined as eGFR<60ml/min/1.73m2 (CKPD- EPI) or/and UACR>200mg/g Initiating treatment with empagliflozin 10mg once daily as add on treatment
Exclusion Criteria:
- Patients already treated with an SGLT-2 inhibitor
- Patients with Hb<11gr/dl or>16gr/dl
- Patients with history of inherited or acquired hemoglobin disease
- Patients with history of hemolytic anemia
- Patients with history of hematologic malignancy or myelodysplastic syndrome or myeloproliferative syndrome
- Patients treated within the last 6 months for anemia due to iron, B12 or folate deficiency
- Patients with history of major hemorrhage or major operation leading to RBC transfusion within the last 3 months.
- Patients planning major operation or revascularization procedure within the 12 following weeks
- Patients treated with erythropoietin
- Patients with Chronic Kidney Disease and GFR<30ml/min/1.73m2
- Pregnancy
- Women of childbearing age not receiving appropriate contraception measures