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Showing 43 results for “Heart Failure”.

September 2022

Iron Deficiency in Heart Failure and Effect of Dapagliflozin: Findings From DAPA-HF

Circulation 2022; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.060511

In this post hoc analysis of DAPA-HF, 43.7% of participants had iron deficiency at baseline, which was associated with worse outcomes. Dapagliflozin appeared to increase iron use but improved outcomes, irrespective of iron status at baseline.

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August 2022

Uric Acid and Sodium-Glucose Cotransporter-2 Inhibition With Empagliflozin in Heart Failure With Reduced Ejection Fraction: The EMPEROR-Reduced Trial

Eur Heart J 2022; online ahead of print doi.org/10.1093/eurheartj/ehac320

Hyperuricaemia is common in heart failure (HF) and is an independent predictor of advanced disease severity and increased mortality. This analysis from EMPEROR-Reduced showed that empagliflozin induced a rapid and sustained reduction of both serum uric acid (SUA) and of clinical events related to hyperuricaemia.

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Empagliflozin Improves Outcomes in Patients With Heart Failure and Preserved Ejection Fraction Irrespective of Age

J Am Coll Cardiol 2022;80(1):1-18 doi: 10.1016/j.jacc.2022.04.040

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce cardiovascular death and hospitalisation for heart failure (HHF) in patients with HFpEF, and are recommended in recent guidelines for heart failure with reduced ejection fraction (HFrEF), supported by Class IA evidence. Typically, HFpEF patients are older than HFrEF, and have a higher mortality risk associated with older age, while the risk for cardiovascular death is lower than in HFrEF. Until now, the treatment effects and safety of SGLT2i in relation to age have not been studied. This prespecified analysis of the EMPEROR-Preserved trial examined the interplay of age and empagliflozin treatment effects.

For patients on placebo, the incidence of primary outcomes and cardiovascular death increased with age. In contrast, empagliflozin reduced the primary outcome, first HHF, and first and recurrent HHF across all age groups. Empagliflozin also improved health-related quality of life, and attenuated the decline of eGFR without age interaction. Additionally, there were no clinically relevant differences in AEs between empagliflozin and placebo across the age groups, and elderly patients tolerated the treatment well.

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July 2022

Effects of Canagliflozin Versus Finerenone on Cardiorenal Outcomes: Exploratory Post Hoc Analyses From FIDELIO-DKD Compared to Reported CREDENCE Results

Nephrol Dial Transplant 2022;37:1261-9 doi.org/10.1093/ndt/gfab336

This analysis highlights the pitfalls of direct comparisons between trials, since when key differences in design are considered, FIDELIO-DKD and CREDENCE demonstrate similar cardiorenal benefits. The authors conclude that both canagliflozin and finerenone are similarly effective in reducing the risk of cardiorenal outcomes.

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Empagliflozin and Serum Potassium in Heart Failure: An Analysis From Emperor-Pooled

Eur Heart J 2022; online ahead of print DOI: 10.1093/eurheartj/ehac306

In this pooled analysis, empagliflozin reduced the incidence of hyperkalaemia without significant increase in hypokalaemia.

Potassium is essential for normal cellular function, but severe potassium abnormalities can lead to cardiac arrhythmias and death. Hyperkalaemia frequently leads to interruption and discontinuation of neurohormonal antagonists, which may worsen the prognosis for people with heart failure (HF).

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Empagliflozin and Incidence of Events Consistent With Acute Kidney Injury: Pooled Safety Analysis in More Than 15,000 Individuals

Diabetes Obes Metab 2022;24:1390-3 doi: 10.1111/dom.14694

In this pooled analysis of patients from the global empagliflozin trial programme, the risk of acute kidney injury (AKI) and acute kidney disease (AKD) with empagliflozin was comparable with placebo. This comprehensive analysis indicates that empagliflozin is not associated with an increased risk of acute kidney failure compared with placebo treatment.

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June 2022

Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin: A Cohort Study

Ann Intern Med 2022; doi:10.7326/M21-4012

This cohort study found that those initiating a SGLT2i as their first-line treatment for T2D showed a similar risk for a composite outcome of MI, stroke, and mortality – and lower risk for a composite of hospitalisation for heart failure (HHF) and mortality. Compared with those receiving metformin as their first-line treatment, the SGLT2i safety profile was similar, except for an increased risk of genital infections.

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Prognostic Implications of N-terminal Pro-B Type Natriuretic Peptide and High-Sensitivity Cardiac Troponin T in EMPEROR-Preserved

JACC Heart Fail 2022 doi:S2213-1779(22)00302-X

This planned analysis from EMPEROR-Preserved provides strong evidence for both N-terminal pro-B type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) as important disease markers and prognostic indicators in people with heart failure with preserved ejection fraction (HFpEF).

Evaluation and management of individuals with HFpEF can be challenging. NT-proBNP and hs-cTnT are biomarkers with well-established prognostic role across the range of ejection fraction in heart failure. As such, it is possible that patient baseline values could be used to identify those suitable for treatment. However, ambiguity has led to confusion about pharmacologic management, and the role of  biomarkers.

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