This finding has not been confirmed in other large trials [4] and furthermore it is important to appreciate that people with peripheral vascular disease (PVD) are a group of individuals who have more to gain from the initiation of SGLT-2 inhibitors in relation to protection against risk of cardiovascular death, myocardial infarction, heart failure complications and progression of CKD. This evidence concerns the gene SLC5A2 and heart failure.