SGLT-2 Inhibitor Use in Heart Failure: A Review for Nurses - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/35212658/
1 Clinical Pharmacy Department, Methodist University Hospital, Memphis, Tennessee (Drs March, Lukas, and Cave); University of Tennessee Health Science Center, College of Pharmacy, Memphis (Drs March, Lukas, and Cave); and...
Relevance: The purpose of this review is to summarize available literature focusing on the use of the SGLT-2 inhibitors as adjunctive therapy in heart failure, as well as evaluate mechanisms for heart failure benefit, adverse effects, and practical considerations for using these agents in the clinical setting.
Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study
Source : https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0262831
Patients with type 2 diabetes who have cardiovascular disease and are receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes. In contrast, glimepiride increases cardiovascular hospitalization when combined...
Conclusion/Relevance: Hence, although empagliflozin did not improve endothelial function compared with glimepiride for patients with type 2 diabetes, it did decrease body fluid volumes. Thus, the coronary-protective effect of empagliflozin is not derived from endothelial function protection, but rather from heart failure risk reduction.
NLRP3 inflammasome as a novel therapeutic target for heart failure - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/35191381/
Heart failure (HF) is a leading cause of mortality worldwide. The pathogenesis of HF is complex and has not yet been fully elucidated, which has slowed drug development and long-term...
Relevance: In this study, we systematically summarize evidence regarding the relationship among NLRP3 inflammasome, energy metabolism, intestinal microflora metabolites, and inflammation, as well as highlight advantages of NLRP3 inflammasome in treating HF.
Impact of Sodium-Glucose Co-Transporter-2 Inhibitors (SGLT2i) On Cardiac Bioenergetic Properties and Cardiorespiratory Fitness: A Special Effect of SGLT2i In Heart Failure? - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/35191660/
Recent clinical trials have highlighted the profound benefits of Sodium-glucose linked transporter 2 inhibitors (SGLT2i) on cardiovascular mortality and hospitalization for heart failure patients. Modest improvements in glycemic, lipid or...
Conclusion/Relevance: In this review, we discuss the current evidence supporting a shift in myocardial substrate utilization from carbohydrates and fat oxidation towards energy efficient ketone bodies in the failing heart and the role of SGLT2i in this key metabolic adaptation to optimize myocardial fuel energetics. Further insights into the...
Reconsidering the ejection fraction centric view of pharmacologic treatment for heart failure - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/35191586/
For the past two decades, heart failure (HF) has been classified into two phenotypes based on ejection fraction (EF). Inhibitors of the RAAS, neprilysin, , and beta-blockers represent foundational treatments...
Conclusion/Relevance: In the EMPEROR trials, empagliflozin reduced the risk of total HF hospitalizations by approximately 30% in patients with EF ranging from 60-65%. Since patients with an EF >60% represent only 10-15% of all HF patients, we propose that foundational HF treatments should be applied to patients across broad range of EF.
The effect of empagliflozin on p wave peak time and other p wave parameters in patients with diabetes mellitus
Source : https://onlinelibrary.wiley.com/doi/10.1111/pace.14463
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between...
Conclusion: We found shortening of PWPT, PWdis, and PWD as reflections of improvements in LA volume and LV diastolic function on ECG after empagliflozin treatment.
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Heart Failure Connect4yrKey Points • Source: Pacing and Clinical Electrophysiology • Conclusions/Relevance: “We found shortening of PWPT, PWdis, and PWD as reflections of improvements in LA volume and LV diastolic function on ECG after empagliflozin Show More
Stopping Empagliflozin Unmasks Heart Failure
About 40% of patients with heart failure (HF) also have type 2 diabetes mellitus (T2DM). 1 Certain sodium-glucose cotransporter-2 (SGLT2) inhibitors have benefited patients with HF. 2 We report a...
Relevance: SGLT2 inhibitors have been shown to have a role in the management of heart failure in patients with type 2 diabetes mellitus, but there is a risk of exacerbation when discontinued.
Effect of empagliflozin on coronary microvascular function in patients with type 2 diabetes mellitus-A randomized, placebo-controlled cross-over study
Source : https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263481
Purpose Results from large scale cardiovascular outcome trials in patients with type 2 diabetes mellitus (DM2) have found that sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce cardiovascular death and hospitalization for...
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Conclusions: Despite effect on weight-loss, Hba1c and biomarkers, treatment with empagliflozin for 12 weeks did not improve CFVR in patients with DM2.
Branched-Chain Amino Acid Metabolism in the Failing Heart - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/35150384/
Branched-chain amino acids (BCAAs) are essential amino acids which have critical roles in protein synthesis and energy metabolism in the body. In the heart, there is a strong correlation between...
Conclusion: Dietary and pharmacological interventions that enhance cardiac BCAA oxidation and limit the accumulation of cardiac BCAAs and BCKAs have been shown to have cardioprotective effects in the setting of ischemic heart disease and heart failure. Thus, targeting cardiac BCAA oxidation may be a promising therapeutic approach for heart...
New therapeutic options for patients with heart failure with reduced ejection fraction and acute decompensated heart failure - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/35101654/
Peri-discharge initiation of treatment with new molecules is possible and safe for patients with HFrEF and ADHF. New molecules, if administered before discharge or shortly after, reduce the risk of...
Conclusions: Peri-discharge initiation of treatment with new molecules is possible and safe for patients with HFrEF and ADHF. New molecules, if administered before discharge or shortly after, reduce the risk of cardiovascular death or worsening heart failure within the vulnerable phase, and are also nephroprotective.
SGLT2 Inhibitors in Older Adults with Heart Failure with Preserved Ejection Fraction - Drugs & Aging
Source : https://link.springer.com/article/10.1007/s40266-022-00920-7
Heart failure is an important medical condition that is prevalent in older adults. Multiple therapies have been identified that improve clinical outcome in heart failure with a reduced ejection fraction....
Relevance: In this current opinion article, we have therefore provided more information on how to translate the findings of the EMPEROR-Preserved trial to the setting of older adults, with a focus on the impact of empagliflozin on hospitalizations, both heart failure-related and all-cause. To better understand the importance of...
Egyptian expert opinion for the use of sodium‐glucose cotransporter‐2 inhibitors in patients with heart failure with reduced ejection fraction
Source : https://onlinelibrary.wiley.com/doi/10.1002/ehf2.13811
Magdy Abdelhamid , Corresponding Author Magdy Abdelhamid Faculty of Medicine, Kasr Al Ainy, Cardiology Department, Cairo University, Cairo, Egypt Correspondence to: Magdy Abdelhamid, Faculty of Medicine, Kasr Al Ainy, Cardiology...
Relevance: Considering the magnitude of the problem and the expected benefit on the target population, an Egyptian consensus document was conducted to demonstrate the importance of and the critical knowledge needed for effective and safe implementation of SGLT2i in the daily practice for the management of patients with HFrEF.
Empagliflozin improves quality of life in nondiabetic HFrEF patients. Sub-analysis of the EMPATROPISM trial
Source : https://www.sciencedirect.com/science/article/abs/pii/S1871402122000315?via=ihub
Empagliflozin proves benefit on health status in the non-diabetic, ethnic minority represented, EMPATROPISM trial population. * A significant mean improvement of 22 points in Kansas City Cardiomyopathy Questionnaire (KCCQ) was...
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Conclusions: Empagliflozin benefits quality of life in the non-diabetic, ethnic minority represented, EMPATROPISM trial population.
Effect of Severe Renal Impairment on the Safety, Tolerability, and Pharmacokinetics of AMG 986 - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/35092583/
Introduction: AMG 986 is a first-in-class, novel apelin receptor small molecule agonist initially developed for the treatment of heart failure (HF). The safety and pharmacokinetics (PK) of AMG 986 in...
Conclusions: The results of this study support the enrollment of HF patients with RI to clinical trials of AMG 986 without the need for dose adjustments.
Mesenchymal Stromal Cell Exosomes in Cardiac Repair - Current Cardiology Reports
Source : https://link.springer.com/article/10.1007/s11886-022-01660-1
Purpose of the Review Mesenchymal stromal cells (MSCs) are considered an attractive option for cell-based therapy because of their immune-privileged phenotype and paracrine activity. Substantial preclinical evidence indicates that MSC...
Conclusion/Relevance: MSC Exosomes appear to be leading candidates to treat myocardial infarction and subsequent heart failure by carrying rich cargo from their parental cells. However, more clinical and pre-clinical studies on MSC exosomes will be required to confirm the beneficial effect to treat cardiovascular diseasesinterventions for...
Highlights of Cardiovascular Disease Studies Presented at the 2021 American Heart Association Scientific Sessions - Current Atherosclerosis Reports
Source : https://link.springer.com/article/10.1007/s11883-022-00985-0
Purpose of Review This review highlights major studies across a broad array of topics presented at the virtual 2021 American Heart Association (AHA) Scientific Sessions. Recent Findings.
Conclusion: Research presented at the 2021 AHA Scientific Sessions emphasized the importance of interventions for cardiovascular disease prevention.
Emerging Horizons in Heart Failure with Preserved Ejection Fraction: The Role of SGLT2 Inhibitors - Diabetes Therapy
Source : https://link.springer.com/article/10.1007/s13300-022-01204-4
Heart failure with preserved ejection fraction (HFpEF) is a condition with increasing disease burden. Prevalence of HFpEF is increasing, reflecting an increasingly elderly and comorbid population, as well as reinforcing...
Conclusion/Relevance: The European Society of Cardiology (ESC) recently added SGLT2 inhibitors to their guidelines for treatment of heart failure with reduced ejection fraction (HFrEF) following DAPA-HF and EMPEROR-Reduced trials and we suggest that similar changes be made to guidelines to support the use of SGLT2 inhibitors in the management...
Conclusions: Independently associated with a higher risk of death during hospitalization, although the strength of this association varies according to the underlying admission diagnosis. These data highlight the importance of PH in patients with cardiac critical illness.
Comparison of prognostic impact of anticoagulants in heart failure patients with atrial fibrillation and renal dysfunction: direct oral anticoagulants versus vitamin K antagonists - Heart and Vessels
Source : https://link.springer.com/article/10.1007/s00380-022-02027-w
Although high thromboembolic risk was assumed in elderly patients with heart failure (HF) and atrial fibrillation (AF), inadequate control of prothrombin time/international normalized ratio was often observed in patients using...
Conclusion/Relevance: Compared with VKA therapy, DOAC therapy was associated with lower risk of all-cause mortality in the elderly HF patients with AF and renal dysfunction.
Robustness of outcomes in trials evaluating sodium-glucose co-transporter 2 inhibitors for heart failure - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/35029056/
doi: 10.1002/ehf2.13785. Online ahead of print. 1 Department of Medicine, University of Mississippi, Jackson, MS, USA. 2 Division of Cardiology, Duke University Medical Center, Durham, NC, USA. 3 Division of...
Conclusion: Improvement in the composite outcome of first HF hospitalization or cardiovascular death was highly concordant and robust across sodium-glucose co-transporter 2 inhibitor trials. In contrast, secondary endpoints of all-cause and cardiovascular mortality were statistically fragile, underscoring the need to power trials for mortality...