Clinical Research Directory

Inclusion Criteria: * Onset of type 2 diabetes at ≥30yrs old with no history of ketoacidosis * 40-90yrs old * Any 2 risk factors which include: i) Smoking (ie. current or ex-smokers) ii) Dyslipidaemia (defined as low density lipoprotein ≥2.6mmol/L, triglyceride \>1.7mmol/L or decreased high density lipoprotein cholesterol \<1.04mmol/L \[man\] or \<1.29mmol/L \[woman\] or on lipid-lowering agent)(17, 18) iii) Hypertension (ie. systolic blood pressure \>140mmHg or diastolic blood pressure \>90mmHg or patients treated for hypertension) iv) Obesity (using definition adapted for chinese ethnicity, body mass index \>25kg/m2)(19) v) Family history of premature heart disease (defined as 1st degree relative \[ie. parent or sibling\] with development of atherosclerotic cardiovascular disease or cardiovascular related death \<55 years of age in male and \<65 years of age in female) * HbA1c ≥ 6.5% and \<10.0% Exclusion Criteria: * Angina pectoris or chest discomfort * Prior coronary artery bypass grafts * Coronary artery stenting within 6 months of study enrolment * Previous myocardial infarct * Any contraindication for stress CMR testing * Renal impairment with eGFR \<45ml/min/1.73m2 * Limited life expectancy \<5 years, for example due to pulmonary disease, cancer or significant hepatic failure * Contraindication to dual antiplatelet therapy * Contraindication to empagliflozin or other SGLT2 inhibitors * Unable to take empagliflozin * Patients currently on empagliflozin or given empagliflozin in the last 6 months * Planned need for concomitant cardiac surgery or coronary intervention * Refusal or inability to sign an informed consent. * Potential for non-compliance towards the requirements in the trial protocol (especially the medical treatment) or follow-up visits