SLC5A2 and heart failure: These natriuretic effects may explain the findings in reducing HHF.23 In addition, SGLT2-Is are believed to improve cardiac metabolism by optimizing the use of ketones.23 Last, SGLT2-Is have been associated with the inhibition of cardiac fibrosis, which is considered an important heart failure pathway.24 These mechanisms of action will not be relevant in the pathophysiology of acute ischemia to the myocardium.