Publications
Stay up to date with our literature reviews which are curated by experts to feature the most important publications released each month. Explore our publications for access to concise summary slides for your own use.
Decline in Estimated Glomerular Filtration Rate After Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Secondary Analysis of the DELIVER Randomized Clinical Trial
JAMA Cardiol. 2023; online ahead of print DOI: 10.1001/jamacardio.2023.4664
An initial decline in eGFR often occurs after initiating a SGLT2i and has been observed in patients with diabetes, CKD and HF. A prespecified analysis of DELIVER evaluated the magnitude and frequency of an initial decline in eGFR (within the first month) and its association with CV and renal outcomes in 5,788 patients with HFpEF or HFmrEF.
Keywords:
Mineralocorticoid Receptor Antagonist Use and the Effects of Empagliflozin on Clinical Outcomes in Patients Admitted for Acute Heart Failure: Findings from EMPULSE
Eur J Heart Fail. 2023; online ahead of print DOI: 10.1002/ejhf.2982
In the EMPULSE trial, empagliflozin produced greater clinical benefit than placebo in patients hospitalised for AHF. Although many patients with AHF are treated with MRAs, the interplay between empagliflozin and MRAs in AHF has not been explored. A post-hoc analysis of the EMPULSE trial aimed to evaluate the efficacy and safety of empagliflozin versus placebo according to MRA use at baseline.
Keywords:
Safety of Sodium-Glucose Cotransporter 2 Inhibitors in Elderly Patients with Type 2 Diabetes: A Meta-Analysis of Randomised Controlled Trials
Diabetes Obes Metab 2023 DOI 10.1111/dom.15193
SGLT2is are effective in preventing adverse outcomes of heart failure and chronic kidney disease, which are highly prevalent in the elderly. While SGLT2is are generally well tolerated, elderly patients may be more susceptible to developing AEs reported with this class of drug, such as infections, fracture, and AKI. Clinical experience with SGLT2is in the elderly and very elderly is limited.
Racial Differences in Quality of Life in Patients With Heart Failure Treated With Sodium-Glucose Cotransporter 2 Inhibitors: A Patient-Level Meta-Analysis of the CHIEF-HF, DEFINE-HF, and PRESERVED-HF Trials
Circulation. 2023; DOI: 10.1161/CIRCULATIONAHA.122.063263
Health status outcomes, including symptoms, function and QoL are worse for Black compared with White patients with HF. However, it is not known whether the health status benefits of SGLT2i are similar across races. This patient-level meta-analysis used data from three US-based trials that enrolled a substantial proportion of Black patients (DEFINE-HF, PRESERVED-HF and CHIEF-HF) to assess the effects of SGLT2is versus placebo on health status for Black compared with White patients with HF.
Keywords:
Effect of Canagliflozin on Heart Failure Hospitalization in Diabetes According to Baseline Heart Failure Risk
JACC Heart Fail. 2023. DOI: 10.1016/j.jchf.2023.03.025
In the CANVAS programme, canagliflozin reduced the risk of HF hospitalisation among individuals with T2D. This post hoc analysis evaluated heterogeneity in the treatment effects of canagliflozin on HF hospitalisation according to baseline HF risk as assessed by two diabetes-specific HF risk scores: WATCH-DM (for participants without prevalent HF) and TRS-HFDM (all participants).
Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights From the EMPEROR-Preserved Trial
European Journal of Heart Failure 2023 DOI 10.1002/ejhf.2857
In the EMPEROR-Preserved trial, empagliflozin was found to improve the clinical outcomes of patients with heart failure and preserved ejection fraction (HFpEF). This pre-specified analysis sought to explore the effect of empagliflozin on cardiovascular (CV) and kidney outcomes across different levels of kidney function.
Advances in the Management of Heart Failure with Reduced Ejection Fraction; The Role of SGLT2is, ARNI, Myotropes, Vericiguat, and Anti-inflammatory Agents: A Mini-review
Curr Pharm Des. 2023; online ahead of print DOI: 10.2174/1381612829666230316142450
This mini-review summarises recent data on new treatments for HFrEF. The article highlights that SGLT2i have revolutionised the management of HFrEF via significant reductions in CV mortality and HF hospitalisations. The role of sacubitril/valsartan as a potential replacement for ACEis and ARBS is discussed. New data on promising disease-modifying therapies are highlighted including vericiguat, which restores the impaired cyclic guanosine monophosphate pathway, and omecamtiv mecarbil, which stimulates cardiac myosin without marked arrhythmogenesis. The lack of success in developing anti-inflammatory agents for HFrEF, despite inflammasome activity being implicated in HFrEF pathophysiology, is discussed.
Keywords:
Patient Characteristics, Outcomes, and Effects of Dapagliflozin According to the Duration of Heart Failure: A Prespecified Analysis of the DELIVER Trial
Circulation 2023; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.062918
Whether the efficacy and safety of SGLT2i therapy are maintained with increasing duration of HFmrEF or HFpEF is unknown. In this prespecified analysis of DELIVER, HF duration was categorised as ≤6 months, >6 to 12 months, >1 to 2 years, >2 to 5 years, or >5 years.
Keywords:
Efficacy of Empagliflozin in Heart Failure with Preserved versus Mid-range Ejection Fraction: a Pre-specified Analysis of EMPEROR-Preserved
Nat Med. 2022;28:2512–2520 DOI: 10.1038/s41591-022-02041-5
Results from EMPEROR-Preserved demonstrated that empagliflozin improved CV death and HF hospitalisation – the primary outcome – in patients with HF and LVEF >40%. This pre-specified analysis of EMPEROR-Preserved aimed to evaluate the effect of empagliflozin in patients with HFpEF (LVEF ≥50%) compared with patients who had HFmrEF (LVEF 41–49%).
Keywords:
Empagliflozin, Irrespective of Blood Pressure, Improves Outcomes in Heart Failure with Preserved Ejection Fraction: the EMPEROR-Preserved Trial
Eur Heart J. 2022; online ahead of print DOI: 10.1093/eurheartj/ehac693
Results from EMPEROR-Preserved demonstrated that empagliflozin improved CV and renal outcomes in patients with HFpEF, but its efficacy and safety with baseline SBP is not well established.