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Once the substrate is appropriately positioned, the activated serine nucleophile of the catalytic triad (Ser630) can attack the peptide bond between the second and third residue, and form a tetrahedral covalent intermediate

In addition, a double-blind trial examining the cardiovascular efficacy and safety of ertugliflozin in patients with T2DM stratified by ejection fraction, showing that dapagliflozin diminished HHF in patients with or without HFrEF [78]