Clinical Research Directory

Inclusion Criteria: * Willing to provide written informed consent. * Signs and symptoms of suspected ischemia that prompted referral for further evaluation by cardiac catheterization or coronary computed tomography within two years of consent. * No evidence of obstructive epicardial coronary artery disease (stenosis \>50%) of a major epicardial vessel (\>3mm) or a fractional flow reserve \>0.80 by invasive catheterization or coronary computed tomography. (Participants who have not undergone cardiac catheterization or coronary angiogram within the last 2 years for their clinical care will be screened with computed angiogram of the coronary arteries to confirm eligibility). * Estimated glomerular filtration rate ≥30ml/min/1.73m2 at enrollment * For subjects having a history of type 2 diabetes mellitus: approval of diabetes care/prescribing provider Exclusion Criteria: * History of non-ischemic cardiomyopathy with left ventricular ejection fraction \<40% or hypertrophic cardiomyopathy. * History of congestive heart failure, severe pulmonary disease, liver disease * History of Acute coronary syndrome within previous 30 days * Stroke within the last 180 days or intracranial hemorrhage at any time. * Severe Valvular disease * Life expectancy \<3 years, due to non-cardiovascular comorbidity. * Pregnancy or women who are breast-feeding * Type 1 diabetes mellitus * History of diabetic ketoacidosis in subjects with Type 2 Diabetes Mellitus * Symptomatic hypotension or systolic blood pressure \<95 mmHg on 2 consecutive measurements * Active malignancy requiring treatment at the time of visit * Severe, unstable, or rapidly progressing renal disease at the time of randomization * History of recurrent urinary tract, bladder, or kidney infections