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Of note, subjecting pigs to myocardial ischemia reperfusion combined with short term pretreatment with canagliflozin preserved cardiac function and efficiency during ischemia but had no effect on the pattern of myocardial substrate uptake, including ketone bodies, potentially arguing against the thrifty substrate hypothesis, although energy metabolism during ischemia and reperfusion markedly differs from substrate utilization in chronic HF or DbCM [146]

Future efforts should focus on developing strategies to enable multi-drug encapsulation, enhance long-term stability, and personalize treatments based on patient-specific data

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E: extended strand

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