Background: Patients with type II diabetes are at major risk for cardiovascular disease. Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) have demonstrated benefit for these patients. The purpose of this study is to determine whether SGLT-2 inhibitors significantly reduce heart failure readmission rates and improve outcomes in patients with congestive heart failure (CHF). Methods: Patient data was pulled on CHF patients with an active prescription for an SGLT-2 inhibitor, and it was analyzed using Fischer's Exact tests and two-tailed t-tests. The primary outcome was a 6-month hospital readmission rate due to CHF while taking SGLT-2 inhibitors. Secondary outcomes included 6-month all-cause hospital readmissions, renal function as measured by an estimated glomerular filtration rate change between admissions, mortality rates, and ejection fraction. Results: Of the 138 patients that met inclusion criteria for the first admission, the 6-month all-cause readmission rate for CHF patients still taking SGLT-2 inhibitors at readmission was 21 percent vs 16 percent (p=0.6) for the control group not taking SGLT-2 inhibitors. The 6-month CHF readmission rate in patients taking SGLT-2 inhibitors was 7.2 percent, and a CHF specific readmission rate was not collected for the control group. In patients with an eGFR less than 90, the average eGFR for the SGLT-2 group declined slightly but was not significant between patients at first admission and those with readmission (p=0.21). Conclusion: The use of SGLT-2 inhibitors in patients with CHF did not change the overall hospital readmission rate; however, larger randomized controlled trials are needed for further evaluation of the potential benefit.

Despite brushing and/or flossing their teeth twice daily, many people are still susceptible to dental cavities and tooth decay. This research investigates the genetic and cardiovascular health behind this phenomenon. Two gene variants related to taste pathways, taste 1 receptor member 2 (TAS1R2) and taste 2 receptor member 38 (TAS2R38), were tested on the DNA of 20 students at Northern State University (10 males and 10 females). In concert with genetic screening, tooth impressions were taken of the participants’ upper and lower jaws along with salivary pH, heart rates, and blood pressures. Participants’ cavities and fillings were counted and their gums examined for inflammation. Results showed that seven out of 10 males and two out of 10 females had the gene variant (TAS1R2). Students with this gene variant had an average salivary pH of 5.22—significantly lower than the salivary pH for the other non-carrier students (p < 0.05). These students also had smaller-sized tooth enamel, with none showing a size greater than one millimeter (x̄ = 0.84 millimeters). Students not expressing the gene variant had fewer cavities than those expressing the TAS1R2 gene variant (i.e., one of the regions amplified). Four of the males and both of the females that carried the gene variant also showed signs of swollen gums, possibly contributing to heart disease in the future. Blood pressures and heart rates for the carriers were statistically significant (p < 0.05), showing higher pressures and faster rates compared to non-carriers; meanwhile, all of the non-carriers had normal pressures and rates. Further, body mass index was lower among individuals without the gene variant. The results this limited study indicate that the TAS1R2 gene variant may play a role in cavity development and impact (or indicate poor) cardiovascular health, highlighting the importance of understanding the role of gene variants with regard to risk of tooth decay and gum and heart disease. KEYWORDS: Dental cavities; Tooth decay; Gum and heart disease; Taste pathway gene; Gene variant; Blood pressure; Heart rate; Salivary pH; Tooth enamel