In a substudy of the EMPA-REG OUTCOME (Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes) trial (95, 96) the HF benefits from use of the SGLT2 inhibitor empagliflozin, including early signs or symptoms of HF were consistent whether or not AF was present at baseline. This evidence concerns the gene SLC5A2 and hydrops fetalis.