Heart Failure Connect
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Effects of Semaglutide on Symptoms, Function, and Quality of Life in Patients With Heart Failure With Preserved Ejection Fraction and Obesity: a Prespecified Analysis of the STEP-HFpEF Trial

Effects of Semaglutide on Symptoms, Function, and Quality of Life in Patients With Heart Failure With Preserved Ejection Fraction and Obesity: a Prespecified Analysis of the STEP-HFpEF Trial

Source : https://pubmed.ncbi.nlm.nih.gov/37952180/

Patients with heart failure (HF) with preserved ejection fraction (HFpEF) and obesity experience high burden of symptoms and functional impairment, and a poor quality of life.

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Rethinking the Impact and Management of Diabetes in Heart Failure Patients

Rethinking the Impact and Management of Diabetes in Heart Failure Patients

Source : https://link.springer.com/article/10.1007/s11897-023-00633-x

The following overview article summarizes the most important aspects of diagnosis and screening and provides an overview on the current evidence of glucose-lowering and heart failure treatment in patients with...

Given the increasing incidence of diabetes and heart failure as well as the impaired prognosis if both comorbidities come together, treatment of these patients requires an interdisciplinary, evidence-based approach to reduce morbidity and mortality in this high-risk population.

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Cardiovascular death and hospitalization in patients with heart failure

The incidence and prevalence of heart failure (HF) has increased in recent years. Experts suggest that this increase in frequency may be due to the growing elderly population with comorbidities such as hypertension and T2DM. Another reason why the number of HF patients has risen could be due to longer survival in those individuals with the condition. HF is a leading cause of hospitalizations, and recurrent HF hospitalization (hFH) predicts cardiovascular (CV) and all-cause mortality. 

In a recent meta-analysis, investigators mined data from various trials, which are grouped by HF presentation as follows:

•Patients with HF with mid-range ejection fraction (HFmrEF) or HF with preserved ejection fraction (HFpEF)

-DELIVER trial (dapagliflozin)

-EMPEROR-Preserved trial (empagliflozin)

•Patients with HF with reduced ejection fraction (HFrEF)

-DAPA-HF trial (dapagliflozin)

-EMPEROR-Reduced trial (empagliflozin)

•Patients with worsening HF regardless of ejection fraction

-SOLOIST-WHF trial (sotagliflozin)

The aim of this meta-analysis was to gauge the effects of SGLT2 inhibitors on different clinical outcomes of heart failure. 

In the trials assessed (n=21,947), SGLT2 inhibitors decreased the risk of composite cardiovascular death or hospitalization for heart failure (HR: 0.77); cardiovascular death (HR: 0.87); first hospitalization for heart failure (HR: 0.72); and all-cause mortality (HR: 0.92) Overall, this meta-analysis demonstrated that SGLT2 inhibitors decreased the risk of cardiovascular death and hospitalizations for heart failure in a broad gamut of heart-failure presentations, thus bolstering their role as foundational therapy for heart failure—regardless of ejection fraction.

What have you found to be effective in reducing the risk of heart-failure hospitalization in your HF patients?

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  • 2yr
    SGLT2 Inhibitors now play an important role in reducing the risk of hospitalization in heart failure patients. Optimal guideline-directed medical therapy is also essential utilizing ACE/ARB/ARNI, diuretics, beta-blockers, Show More
  • 2yr
    Both systolic and diastolic heart failure have unacceptably high mortality. The introduction of drugs like empa, dapa may well improve these high rates. If one considers soloist, rugs like Impefa Show More

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Major Adverse Cardiovascular Events of Vascular Endothelial Growth Factor Tyrosine Kinase Inhibitors Among Patients With Different Malignancy: a Systemic Review and Network Meta-Analysis

Major Adverse Cardiovascular Events of Vascular Endothelial Growth Factor Tyrosine Kinase Inhibitors Among Patients With Different Malignancy: a Systemic Review and Network Meta-Analysis

Source : https://journals.lww.com/jcma/abstract/9900/major_adverse_cardiovascular_events_of_vascular.304.aspx

We searched PubMed, Embase, and ClinicalTrials.gov from inception until August 31, 2021, for phase II/III randomized controlled trials of 11 VEGF-TKIs (axitinib, cabozantinib, lenvatinib, pazopanib, ponatinib, ripretinib, regorafenib, sorafenib, sunitinib,...

The risk of heart failure significantly increased in association with less selective sorafenib (OR: 3.53), pazopanib (OR: 3.10), and sunitinib (OR: 2.65).

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Cardiovascular and Renal Benefit of Novel Non-Steroidal Mineralocorticoid Antagonists in Patients with Diabetes

Cardiovascular and Renal Benefit of Novel Non-Steroidal Mineralocorticoid Antagonists in Patients with Diabetes

Source : https://link.springer.com/article/10.1007/s11886-023-01998-0

Novel non-steroidal mineralocorticoid receptor (MR) antagonists (MRAs) are a new class of drugs blocking adverse MR-mediated effects with an improved benefit-risk profile compared to steroidal MRAs. This review will provide...

This review provide information’s on the preclinical and clinical pharmacology of this new drug class and will discuss its future clinical applications in patients with cardiorenal disease.

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Cumulative HbA1c Exposure as a CVD Risk in Patients With Type 2 Diabetes: a Post Hoc Analysis of ACCORD Trial

Cumulative HbA1c Exposure as a CVD Risk in Patients With Type 2 Diabetes: a Post Hoc Analysis of ACCORD Trial

Source : https://pubmed.ncbi.nlm.nih.gov/37952600/

Higher cumulative HbA1c exposure was significantly associated with an increased risk of the primary outcome, all-cause mortality and cardiovascular death among T2D patients.

Participants in the intensive-therapy group with high baseline HbA1c and cumulative HbA1c exposure had a significantly higher risk of primary outcome, all-cause mortality, and CV-related death.

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Neuropeptide Y Is Elevated in Heart Failure and Is an Independent Predictor of Outcomes

Neuropeptide Y Is Elevated in Heart Failure and Is an Independent Predictor of Outcomes

Source : https://pubmed.ncbi.nlm.nih.gov/37937329/

Peripherally measured NPY is an independent predictor of all-cause and cardiovascular death even after adjustment for other prognostic variables, including BNP.

Peripherally measured NPY is an independent predictor of all cause and CV death even after adjustment for other prognostic variables, including BNP.

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Use of MHT in Women With Cardiovascular Disease: a Systematic Review and Meta-Analysis

Use of MHT in Women With Cardiovascular Disease: a Systematic Review and Meta-Analysis

Source : https://pubmed.ncbi.nlm.nih.gov/37933495/

This systematic review assesses the effect of menopausal hormone therapy (MHT) on cardiovascular outcomes and risk factors in postmenopausal women with cardiovascular disease (CVD).

No significant differences were observed between MHT users and controls regarding primary outcomes of nonfatal MI, CV-related death, or stroke. No differences in frequency of angina, HF, and TIAs were observed.

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Improvement in Serum Magnesium Levels With Sodium-Glucose Cotransporter 2 Inhibitors

Improvement in Serum Magnesium Levels With Sodium-Glucose Cotransporter 2 Inhibitors

Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578385/

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are associated with a modest but significant increase in serum magnesium levels.

SGLT2 inhibitors in patients with diabetes mellitus have been efficacious for glycemic control, renal protection, decreasing the risk of atherosclerotic cardiovascular disease events, and reducing cardiac mortality.

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Impact of SGLT2 Inhibitors on Patient Outcomes: a Network Meta-Analysis

Impact of SGLT2 Inhibitors on Patient Outcomes: a Network Meta-Analysis

Source : https://cardiab.biomedcentral.com/articles/10.1186/s12933-023-02035-8

A comprehensive network meta-analysis comparing the effects of individual sodium-glucose cotransporter 2 (SGLT2) inhibitors on patients with and without comorbidities including diabetes mellitus (DM), heart failure (HF), and chronic kidney...

A network meta-analysis revealed that empagliflozin users with diabetes experienced a lower risk of dying from any cause than those using dapagliflozin.

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Kidneys in Heart Failure: Impact of Flozins and Beyond

Kidneys in Heart Failure: Impact of Flozins and Beyond

Source : https://pubmed.ncbi.nlm.nih.gov/37937356/

Chronic kidney disease (CKD) and heart failure (HF) represent two modern epidemies and are closely related.

SGLT2 inhibitors are cardioprotective in a wide spectrum of eGFR rates, although data for patients with HF with respect to the UAC ratio remain limited.

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Enhanced Levels of Adiposity, Stretch and Fibrosis Markers in Patients With Coexistent Heart Failure and Atrial Fibrillation

Enhanced Levels of Adiposity, Stretch and Fibrosis Markers in Patients With Coexistent Heart Failure and Atrial Fibrillation

Source : https://link.springer.com/article/10.1007/s12265-023-10454-x

The coexistence of heart failure (HF) and atrial fibrillation (AF) worsens the prognosis of patients. We aimed to study the inflammation, metabolism, adiposity, and fibrosis markers on epicardial and subcutaneous...

Plasma FABP4 was identified as the main heart failure (HF) predictor. Higher levels of adiposity markers are associated with atrial fibrillation (AF) or HF and higher stretch and fibrosis markers with combined AF and HF.

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These study results indicated a noteworthy effect of cryoablation in mitigating atrial fibrillation (AF) recurrence, alongside a success rate, denoted by freedom from AF at 1 and 2 years postprocedure.

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Prognostic Impact of Abnormal Sodium Burden in Heart Failure Patients With Preserved Ejection Fraction

Prognostic Impact of Abnormal Sodium Burden in Heart Failure Patients With Preserved Ejection Fraction

Source : https://pubmed.ncbi.nlm.nih.gov/37877605/

In HFpEF patients, abnormal sodium burden was an independent predictor long-term any-cause mortality and HF hospitalization.

In patients with heart failure and preserved ejection fraction, abnormal sodium burden was an independent predictor long-term any-cause mortality and HF hospitalization.

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Utilization Patterns of Cardiovascular Medications in Patients With Diabetes Mellitus: a Retrospective Cross-Sectional Study, 2013-17

Utilization Patterns of Cardiovascular Medications in Patients With Diabetes Mellitus: a Retrospective Cross-Sectional Study, 2013-17

Source : https://pubmed.ncbi.nlm.nih.gov/37848743/

The present study reflects that medication utilization patterns were rational, according to the standard treatment guidelines. Utilization patterns of medications that are recommended for both prevention and treatment of CVD...

Researchers from the Middle East studied the utilization patterns of CVD medications in patients with T2DM for 4 years. Women had the highest rate of utilization of CVD medications across the entire study range. Utilization patterns of medications recommended for prevention and treatment of CVD in diabetes were observed to be the highest.

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Relationship Between Comorbidity and Health Outcomes in Patients With Heart Failure: a Systematic Review and Meta-Analysis

Relationship Between Comorbidity and Health Outcomes in Patients With Heart Failure: a Systematic Review and Meta-Analysis

Source : https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-023-03527-x

Background The prevalence of heart failure (HF) is expected to rise due to increased survivorship and life expectancy of patients with acute heart conditions. Patients with HF and other multiple...

Comorbidities have significantly negative pooled effects on HF patient health outcomes, especially in regard to the prognostic health outcomes. Clinicians should carefully identify and manage these conditions when implementing HF interventions to improve prognostic outcomes.

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Use of Human-Centered Design Methodology to Develop a Digital Toolkit to Optimize Heart Failure Guideline-Directed Medical Therapy

Use of Human-Centered Design Methodology to Develop a Digital Toolkit to Optimize Heart Failure Guideline-Directed Medical Therapy

Source : https://pubmed.ncbi.nlm.nih.gov/37855732/

The clinician, patient, and caregiver insights identified through human-centered design will inform a digital toolkit aimed at optimizing HF GDMTs, including a patient-facing smartphone application and clinician dashboard. This digital...

Researchers engaged key stakeholders in human-centered design sessions to identify challenges in guideline-directed medical therapies optimization posthospitalization and inform the development of a digital toolkit aimed at optimizing HF therapy. Several themes emerged from the clinician, patient, and caregiver sessions on challenges to...

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Summary of the Heart Failure Society of America Annual Scientific Meeting 2023

The 2023 annual scientific meeting of the Heart Failure Society of America (HFSA) took place from Oct. 6 to 9, 2023, at the Huntington Convention Center in Cleveland. The four-day program included the latest information on diagnosing and treating heart failure, including heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).

Click above for our post-conference wrap-up report.

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Empagliflozin Improves Cardiac Energetics During Ischaemia/Reperfusion by Directly Increasing Cardiac Ketone Utilisation

Empagliflozin Improves Cardiac Energetics During Ischaemia/Reperfusion by Directly Increasing Cardiac Ketone Utilisation

Source : https://pubmed.ncbi.nlm.nih.gov/37819017/

Heart failure remains a huge clinical burden. Clinical trials of SGLT2 inhibitors in patients with diabetes and heart failure have reported significant cardio-protection from EMPA treatment that appears independent of...

EMPA causes a switch in metabolism away from glucose oxidation toward increased ketone utilisation in the rat heart, thereby improving function and energetics both during ischaemia and recovery during reperfusion. This preference of ketone utilisation over glucose was observed under conditions of constant supply of substrate, suggesting that...

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Evaluation of the Safety of Inpatient Empagliflozin in a Real-World Setting

Evaluation of the Safety of Inpatient Empagliflozin in a Real-World Setting

Source : https://pubmed.ncbi.nlm.nih.gov/37829225/

This real-world study of empagliflozin use in the inpatient setting found no significant differences in safety endpoints between empagliflozin and other oral antihyperglycemic agents. Larger-scale studies need to be performed...

This real-world study of empagliflozin use in the inpatient setting found no significant differences in safety endpoints between empagliflozin and other oral antihyperglycemic agents. Larger-scale studies need to be performed before the use of empagliflozin can be routinely recommended in the inpatient setting.

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