Among the 122 individuals to whom dapagliflozin was not initiated within the study period, the most common reasons were individuals declining due to being asymptomatic (n = 38), LVEF or NT-proBNP had improved (n = 14), deceased before initiation (n = 11), other heart failure medications were prioritized (n = 10), multimorbidity (n = 9), low renal function (n = 7), hypotension (n = 5), high risk of acidosis (n = 3). This evidence concerns the gene NPPB and heart failure.