Lessons from a pre-specified meta-analysis of sodium-glucose cotransporter-2 (SGLT2) inhibitors in heart failure: Time for new clinical recommendations
Source : https://globalcardiologyscienceandpractice.com/index.php/gcsp/article/view/621
https://doi.org/10.21542/gcsp.2023.14 Cardiovascular disease remains the leading cause of death worldwide with heart failure (HF) being one of the significant contributors to morbidity and mortality. The incidence of HF with preserved...
Conclusions/Relevance: Recent trials have shown reductions in cardiovascular death and heart failure events in patients with mildly reduced or preserved ejection fraction (EF), although with uncertainty around the consistency of clinical benefits across the classes and therapeutic effects.
Racial Differences in Low Natriuretic Peptide Levels: Implications for Heart Failure Clinical Trials
Source : https://www.sciencedirect.com/science/article/abs/pii/S0002870323001631?via=ihub
Some patients with heart failure (HF) have low natriuretic peptide (NP) levels. It is unclear whether specific populations are disproportionately excl...
Conclusions: Nearly 10% of patients hospitalized with HF have unexpectedly low BNP levels. Simulating inclusion into a prototype HFpEF RCT demonstrated that requiring increasingly elevated NP levels disproportionately excludes Black patients.
Cost-effectiveness of adding empagliflozin to the standard of care for patients with heart failure with reduced ejection fraction from the perspective of healthcare system in Malaysia
Source : https://www.frontiersin.org/articles/10.3389/fphar.2023.1195124/full
Objective: The aim of this study was to determine the cost-effectiveness of adding empagliflozin to the standard of care versus SoC alone for the treatment of patients with heart failure...
Conclusion: Empagliflozin + SoC compared to SoC alone for the treatment of HFrEF patients was cost-effective from the perspective of the MoH of Malaysia.
Clinical characteristics and outcomes in Asian patients with heart failure with mildly reduced ejection fraction
Source : https://journals.lww.com/smj/Abstract/9000/Clinical_characteristics_and_outcomes_in_Asian.99905.aspx
rEF) and preserved ejection fraction (HFpEF). Methods: Patients admitted nationally for HF between 2008 and 2014 were included in the study. They were categorised according to ejection fraction (EF). Patients...
Conclusion: HFmrEF patients account for a significant burden of patients with HF. HFmrEF represents a distinct HF phenotype with high atherosclerotic burden and clinical outcomes saddled in between those of HFrEF and HFpEF. Further therapeutic studies to guide management of this challenging group of patients are warranted.
Prescribing patterns and factors associated with sodium-glucose cotransporter-2 inhibitor prescribing in patients with diabetes mellitus and atherosclerotic cardiovascular disease - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/37311594/
We found that 1 in 5 patients with diabetes and atherosclerotic CVD were prescribed SGLT2 inhibitors in 2019/20, whereas statins were prescribed for 4 of every 5 patients. Although SGLT2...
Interpretation: We found that 1 in 5 patients with diabetes and atherosclerotic CVD were prescribed SGLT2 inhibitors in 2019/20, whereas statins were prescribed for 4 of every 5 patients. Although SGLT2 inhibitor prescribing increased over the study period, disparities in adoption by age, sex, socioeconomic status, comorbidities and physician...
Noncardiovascular morbidity and mortality across left ventricular ejection fraction catefories following hospitalization for heart failure
Source : https://www.sciencedirect.com/science/article/abs/pii/S1885585723001585?via=ihub
Introducción y objetivos: Los eventos no cardiovasculares son una importante causa de morbimortalidad en pacientes con insuficiencia cardiaca (IC), pe...
Conclusions: Following an admission for HF, LVEF status was directly associated with the risk of noncardiovascular morbidity and mortality. Patients with HFpEF were at higher risk of noncardiovascular death and total noncardiovascular readmissions, especially those with LVEF ≥ 60%.
Comparison of short and long forms of the Flinders program of chronic disease SELF-management for participants starting SGLT-2 inhibitors for congestive heart failure (SELFMAN-HF): protocol for a prospective, observational study
Source : https://www.frontiersin.org/articles/10.3389/fmed.2023.1059735/full
IntroductionCongestive heart failure (CHF) causes significant morbidity and mortality. It is an epidemic, and costs are escalating. CHF is a chronic disease whose trajectory includes stable phases, periods of decompensation,...
Conclusion: The specific challenges highlighted will be addressed in the creation of hypotheses for future studies. Areas that will be challenging include the CDSM programme for clients from diverse/lower educational and socioeconomic backgrounds where the programme may have variable effectiveness. Delivery to clients placed at the apex of...
Sex differences in cardiovascular outcomes of SGLT-2 inhibitors in heart failure randomized controlled trials: A systematic review and meta-analysis
Source : https://www.sciencedirect.com/science/article/pii/S2666602223000137?via=ihub
In patients with heart failure (HF), randomized controlled trials (RCTs) of sodium-glucose transporter-2 inhibitors (SGLT-2is) have proven to be effec...
Conclusion: SGLT-2is reduce the risk of primary composite outcomes in patients with HF, regardless of sex; however, the benefits were less pronounced in women. Further research needs to be done to better explain these observed differences in outcomes.
Liver tests, cardiovascular outcomes and effects of empagliflozin in patients with heart failure and preserved ejection fraction: the EMPEROR-Preserved Trial - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/37278451/
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Cost-Effectiveness of Dapagliflozin vs Empagliflozin for Treating Heart Failure With Reduced Ejection Fraction in the United States - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/37270374/
The findings of this study indicate that dapagliflozin may offer greater lifetime economic value when compared with empagliflozin. Given that the current clinical practice guideline does not recommend one SGLT2...
Multimodality Imaging and Biomarker Approach to Characterize the Pathophysiology of Heart Failure in Left Ventricular Non-Compaction with Preserved Ejection Fraction - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/37297827/
LVNC patients with HFpEF have diffuse fibrosis, which is more extensive at the apical level, explaining the decrease in apical deformation and overexpression of Galectin-3. Lower transmural and base-to-apex deformation...
Prevalence and Incidence of Atrial Fibrillation in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: (Additive) Value of Implantable Loop Recorders - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/37297876/
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Effects of empagliflozin in women and men with acute myocardial infarction - an analysis from the EMMY trial
Source : https://www.sciencedirect.com/science/article/pii/S1109966623001008?via=ihub
Empagliflozin exerts beneficial cardiac effects in people with acute myocardial infarction. Women with acute myocardial infarction are older and have higher NTproBNP levels than men.
Conclusions: Empagliflozin exhibited similar benefits in women and men when administered immediately after an AMI.
Comparison of the effects of empagliflozin and sotagliflozin on a zebrafish model of diabetic heart failure with reduced ejection fraction - Experimental & Molecular Medicine
Source : https://www.nature.com/articles/s12276-023-01002-3
Two existing drugs used to lower glucose in patients with diabetes also reduce the chances of heart failure by blocking the excessive activity of a protein involved in transport of...
Conclusions/Relevance: These findings suggest that both EMPA and SOTA exert cardioprotective effects in the DM-HFrEF zebrafish model by inhibiting NHE1 activity. In addition, despite the similar cardioprotective effects of the two drugs, SOTA may be less effective than EMPA at high concentrations.
Effect of Canagliflozin on Heart Failure Hospitalization in Diabetes According to Baseline Heart Failure Risk
Source : https://www.sciencedirect.com/science/article/abs/pii/S2213177923001865?via=ihub
In the CANVAS (Canagliflozin Cardiovascular Assessment Study) program, canagliflozin reduced the risk of heart failure (HF) hospitalization among individuals with type 2 diabetes mellitus (T2DM).
Conclusions: Among participants with T2DM, the WATCH-DM and TRS-HFDM can reliably identify those at high risk for HF hospitalization and most likely to benefit from canagliflozin.
SGLT2 Inhibitors: A New Therapeutical Strategy to Improve Clinical Outcomes in Patients with Chronic Kidney Diseases - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/37240080/
The purpose of this manuscript is to review the effects of sodium-glucose cotransport protein 2 inhibitors (SGLT2is) in patients with chronic kidney disease according to basic mechanisms, current recommendations, and...
Conclusions/Relevance: A large unmet need remains to reduce the residual risk in patients with cardiovascular or renal disease. The results from ongoing and future randomized, controlled trials will certainly expand the clinical indications for SGLT-2is in a large range of patients, enabling us to discover and unlock their value beyond the...
Effects of Empagliflozin on Gut Microbiota in Heart Failure with a Preserved Ejection Fraction: The Design of a Pragmatic Randomized, Open-Label Controlled Trial (EMPAGUM)
Heart failure (HF) is a complex clinical disease characterized by symptoms and indications caused by any anatomical or functional impairment of ventricular filling or blood ejection. As one of the...
Relevance: The purpose of the trial is to validate the changes that occur in gut microbiota in patients with HFpEF who take empagliflozin and to investigate the function of gut microbiota and their metabolites in the process.
Evolocumab is Initiated in Central and Eastern Europe at Much Higher LDL-C Levels Than Recommended in Guidelines: Results from the Observational HEYMANS Study - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/37218974/
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Conclusion: In the HEYMANS CEE cohort, patients initiated on evolocumab had baseline LDL-C levels approximately three-fold higher than guideline-recommended thresholds for PCSK9i initiation. Risk-based LDL-C goal attainment was highest in patients receiving high-intensity combination therapy. Lowering the LDL-C reimbursement threshold for...
Meaning: The findings suggest that treatment with empagliflozin in patients with HFpEF should be independent of diuretic therapy and may result in reduced need for diuretics.
Association Between Change in Ambulatory Pulmonary Artery Pressures and Natriuretic Peptides in Patients with Heart Failure: Results from the EMBRACE-HF Trial - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/37230315/
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Conclusion: We observed that short-term reductions in ambulatory PADP appear to be associated with decreases in NT-proBNP. This finding may provide additional clinical context when tailoring treatment for patients with heart failure.