The cardiovascular outcome trial investigating the effects of dapagliflozin has not been reported yet, however, the CVD-REAL (comparative effectiveness of cardiovascular outcomes in new users of SGLT-2 inhibitors) although not being a randomized controlled trial also suggests a reduction in mortality and HF hospitalization the real world setting, confirming the findings from the EMPA-REG-OUTCOME trial and the CANVAS program, suggesting a potential drug class effect at least on some of the outcome parameters (Kosiborod et al., 2017). This evidence concerns the gene SLC5A2 and hydrops fetalis.