Men and women aged 18 years or older with a diagnosis of heart failure for at least 2 months are eligible if they are in New York Heart Association functional class II or above, have a left ventricular ejection fraction documented to be ≤ 40% within the last 12 months, are optimally treated with pharmacological and device therapy for heart failure, and willing to provide written informed consent. In addition, patients must have a N‐terminal pro B‐type natriuretic peptide concentration ≥ 600 pg/mL or, if hospitalised for heart failure within the previous 12 months, ≥ 400 pg/mL. Patients with atrial fibrillation or atrial flutter must have a level ≥ 900 pg/mL, irrespective of history of heart failure hospitalization. Full details are provided in the online supplementary Appendix S1.
Key exclusion criteria include: recent treatment with or intolerance of a SGLT2 inhibitor, type 1 diabetes mellitus, symptoms of hypotension or systolic blood pressure < 95 mmHg, recent worsening heart failure or other cardiovascular events or procedures (or planned procedures), estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 (or rapidly declining renal function) and other conditions likely to prevent patient participation in the trial or greatly limit life expectancy. A full list of exclusion criteria is provided in Table1 .
Key exclusion criteria include: recent treatment with or intolerance of a SGLT2 inhibitor, type 1 diabetes mellitus, symptoms of hypotension or systolic blood pressure < 95 mmHg, recent worsening heart failure or other cardiovascular events or procedures (or planned procedures), estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 (or rapidly declining renal function) and other conditions likely to prevent patient participation in the trial or greatly limit life expectancy. A full list of exclusion criteria is provided in Table
