المؤلفون: Butler, Javed, Anker, Stefan D., Lund, Lars H, Coats, Andrew J. S., Filippatos, Gerasimos, Siddiqi, Tariq Jamal, Friede, Tim, Fabien, Vincent, Kosiborod, Mikhail, Metra, Marco, Piña, Ileana L., Pinto, Fausto J., Rossignol, Patrick, van der Meer, Peter, Bahit, Cecilia, Belohlavek, Jan, Böhm, Michael, Brugts, Jasper J., Cleland, John G. F., Ezekowitz, Justin, Bayes-Genis, Antoni, Gotsman, Israel, Goudev, Assen, Khintibidze, Irakli, Lindenfeld, Joann, Mentz, Robert J., Merkely, Bela, Montes, Eliodoro Castro, Mullens, Wilfried, Nicolau, Jose C., Parkhomenko, Aleksandr, Ponikowski, Piotr, Seferovic, Petar M., Senni, Michele, Shlyakhto, Evgeny, Cohen-Solal, Alain, Szecsödy, Peter, Jensen, Klaus, Dorigotti, Fabio, Weir, Matthew R., Pitt, Bertram

مصطلحات موضوعية: Heart failure with reduced ejection fraction, Hyperkalemia, Patiromer, Potassium-binding polymer, Renin–angiotensin–aldosterone system inhibitor (RAASi)

الوصف: © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0Test/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. F ; Aims: To investigate the impact of patiromer on the serum potassium level and its ability to enable specified target doses of renin-angiotensin-aldosterone system inhibitor (RAASi) use in patients with heart failure and reduced ejection fraction (HFrEF). Methods and results: A total of 1642 patients with HFrEF and current or a history of RAASi-related hyperkalemia were screened and 1195 were enrolled in the run-in phase with patiromer and optimization of the RAASi therapy [≥50% recommended dose of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor, and 50 mg of mineralocorticoid receptor antagonist (MRA) spironolactone or eplerenone]. Specified target doses of the RAASi therapy were achieved in 878 (84.6%) patients; 439 were randomized to patiromer and 439 to placebo. All patients, physicians, and outcome assessors were blinded to treatment assignment. The primary endpoint was between-group difference in the adjusted mean change in serum potassium. Five hierarchical secondary endpoints were assessed. At the end of treatment, the median (interquartile range) duration of follow-up was 27 (13-43) weeks, the adjusted mean change in potassium was +0.03 mmol/l in the patiromer group and +0.13 mmol/l in the placebo group [difference in the adjusted mean change between patiromer and placebo: -0.10 mmol/l (95% confidence interval, CI -0.13, 0.07); P < 0.001]. Risk of hyperkalemia >5.5 mmol/l [hazard ratio (HR) 0.63; 95% CI 0.45, 0.87; P = 0.006), reduction of MRA dose (HR 0.62; 95% CI 0.45, 0.87; P = 0.006), and total adjusted hyperkalemia events/100 ...

العلاقة: https://academic.oup.com/eurheartjTest; Eur Heart J. 2022 Nov 1;43(41):4362-4373; http://hdl.handle.net/10451/61692Test

الإتاحة: https://doi.org/10.1093/eurheartj/ehac401Test
http://hdl.handle.net/10451/61692Test

المؤلفون: Welsh, Aimee, Hammad, Muhammad, Piña, Ileana L, Kulinski, Jacquelyn

المصدر: European Journal of Preventive Cardiology ; ISSN 2047-4873 2047-4881

الوصف: Obesity has risen to epidemic levels worldwide over the past few decades and has become a huge global health burden owing to its direct contribution to the development of some of the most prevalent chronic diseases including diabetes, hypertension, hyperlipidaemia, and other cardiovascular diseases. Obesity is a disease of positive energy balance resulting from complex interactions between abnormal neurohumoral responses and an individual’s socioeconomic, environmental, behavioural, and genetic factors leading to a state of chronic inflammation. Understanding the complex nature of the disease is crucial in determining the best approach to combat its rising numbers. Despite recent advancements in pharmacological therapy for the treatment of obesity, reversing weight gain and maintaining weight loss is challenging due to the relapsing nature of the disease. Prevention, therefore, remains the key which needs to start in utero and continued throughout life. This review summarizes the role obesity plays in the pathophysiology of various cardiovascular diseases both by directly affecting endothelial and myocyte function and indirectly by enhancing major cardiovascular risk factors like diabetes, hypertension, and hyperlipidaemia. We highlight the importance of a holistic approach needed to prevent and treat this debilitating disease. Particularly, we analyse the effects of plant-based diet, regular exercise, and non-exercise activity thermogenesis on obesity and overall cardiorespiratory fitness. Moreover, we discuss the significance of individualizing obesity management with a multimodal approach including lifestyle modifications, pharmacotherapy, and bariatric surgery to tackle this chronic disease.

الإتاحة: https://doi.org/10.1093/eurjpc/zwae025Test

المؤلفون: Benjamin, Emelia J, Al‐Khatib, Sana M, Desvigne‐Nickens, Patrice, Alonso, Alvaro, Djoussé, Luc, Forman, Daniel E, Gillis, Anne M, Hendriks, Jeroen ML, Hills, Mellanie True, Kirchhof, Paulus, Link, Mark S, Marcus, Gregory M, Mehra, Reena, Murray, Katherine T, Parkash, Ratika, Piña, Ileana L, Redline, Susan, Rienstra, Michiel, Sanders, Prashanthan, Somers, Virend K, Van Wagoner, David R, Wang, Paul J, Cooper, Lawton S, Go, Alan S

المصدر: Journal of the American Heart Association. 10(16)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Research, Comparative Effectiveness Research, Cardiovascular, Prevention, Clinical Trials and Supportive Activities, Heart Disease, Stroke, Good Health and Well Being, Animals, Anti-Arrhythmia Agents, Atrial Fibrillation, Biomedical Research, Body Composition, Cardiac Rehabilitation, Comorbidity, Disease Progression, Health Priorities, Health Services Needs and Demand, Healthy Lifestyle, Humans, National Heart, Lung, and Blood Institute (U.S.), Needs Assessment, Recurrence, Research Design, Risk Assessment, Risk Factors, Secondary Prevention, Treatment Outcome, United States, Weight Loss, atrial fibrillation, cardiac rehabilitation, prevention, research, risk factors, sleep, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology

الوصف: There has been sustained focus on the secondary prevention of coronary heart disease and heart failure; yet, apart from stroke prevention, the evidence base for the secondary prevention of atrial fibrillation (AF) recurrence, AF progression, and AF-related complications is modest. Although there are multiple observational studies, there are few large, robust, randomized trials providing definitive effective approaches for the secondary prevention of AF. Given the increasing incidence and prevalence of AF nationally and internationally, the AF field needs transformative research and a commitment to evidenced-based secondary prevention strategies. We report on a National Heart, Lung, and Blood Institute virtual workshop directed at identifying knowledge gaps and research opportunities in the secondary prevention of AF. Once AF has been detected, lifestyle changes and novel models of care delivery may contribute to the prevention of AF recurrence, AF progression, and AF-related complications. Although benefits seen in small subgroups, cohort studies, and selected randomized trials are impressive, the widespread effectiveness of AF secondary prevention strategies remains unknown, calling for development of scalable interventions suitable for diverse populations and for identification of subpopulations who may particularly benefit from intensive management. We identified critical research questions for 6 topics relevant to the secondary prevention of AF: (1) weight loss; (2) alcohol intake, smoking cessation, and diet; (3) cardiac rehabilitation; (4) approaches to sleep disorders; (5) integrated, team-based care; and (6) nonanticoagulant pharmacotherapy. Our goal is to stimulate innovative research that will accelerate the generation of the evidence to effectively pursue the secondary prevention of AF.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9r84k5c2Test

المؤلفون: Reza, Nosheen, Tahhan, Ayman Samman, Mahmud, Nadim, DeFilippis, Ersilia M, Alrohaibani, Alaaeddin, Vaduganathan, Muthiah, Greene, Stephen J, Ho, Annie Hang, Fonarow, Gregg C, Butler, Javed, O’Connor, Christopher, Fiuzat, Mona, Vardeny, Orly, Piña, Ileana L, Lindenfeld, JoAnn, Jessup, Mariell

المصدر: Circulation Heart Failure. 13(8)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Medical Physiology, Cardiovascular Medicine and Haematology, Cardiovascular, Heart Disease, Clinical Research, Clinical Trials and Supportive Activities, Gender Equality, Authorship, Cardiology, Europe, Female, Humans, Manuscripts, Medical as Topic, Publishing, United States, Women, clinical trial, guideline, heart failure, publications, women, Biochemistry and Cell Biology, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Medical physiology

الوصف: BackgroundGender disparities in authorship of heart failure (HF) guideline citations and clinical trials have not been examined.MethodsWe identified authors of publications referenced in Class I Recommendations in United States (n=173) and European (n=100) HF guidelines and of publications of all HF trials with >400 participants (n=118) published between 2001 and 2016. Authors' genders were determined, and changes in authorship patterns over time were evaluated with linear regression and nonparametric testing.ResultsThe median proportion of women authors per publication was 20% (interquartile range [IQR], 8%-33%) in United States guidelines, 14% (IQR, 2%-20%) in European guidelines, and 11% (IQR, 4%-20%) in HF trials. The proportion of women authors increased modestly over time in United States and European guidelines' references (β=0.005 and 0.003, respectively, from 1986 to 2016; P0.50). Overall proportions of women as first or last authors in HF trials (16%) did not change significantly over time (P=0.60). North American HF trials had the highest likelihood of having a woman as first or senior author (24%). HF trials with a woman first or senior author were associated with a higher proportion of enrolled female participants (39% versus 26%, P=0.01).ConclusionsIn HF practice guidelines and trials, few women are authors of pivotal publications. Higher number of women authors is associated with higher enrollment of women in HF trials. Barriers to authorship and representation of women in HF guidelines and HF trial leadership need to be addressed.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/8vr3z7q0Test

المؤلفون: Khan, Muhammad Shahzeb, Butler, Javed, Anker, Stefan, D, Filippatos, Gerasimos, Ferreira, João Pedro, Pocock, Stuart, J, Januzzi, James, L, Piña, Ileana, L, Böhm, Michael, Ponikowski, Piotr, Verma, Subodh, Brueckmann, Martina, Vedin, Ola, Zeller, Cordula, Zannad, Faiez, Packer, Milton

المساهمون: Duke University Durham, Baylor Scott and White Research Institute Dallas, TX, USA, Department of Medicine, University of Mississippi School of Medicine, Berlin-Brandenburg Center for Regenerative Medicine Berlin, Germany (BCRT), Charité - UniversitätsMedizin = Charité - University Hospital Berlin, German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), Wrocław Medical University, National and Kapodistrian University of Athens (NKUA), “Attikon” University Hospital, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique plurithématique Pierre Drouin Nancy (CIC-P), Centre d'investigation clinique Nancy (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists Vandoeuvre-les-Nancy (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu Nancy, French-Clinical Research Infrastructure Network - F-CRIN Paris (Cardiovascular & Renal Clinical Trialists - CRCT ), London School of Hygiene and Tropical Medicine (LSHTM), Massachusetts General Hospital Boston, Central Michigan University (CMU), Wayne State University Detroit, Saarland University Saarbrücken, University of Wrocław Poland (UWr), St. Michael's Hospital, Boehringer Ingelheim International GmbH, Universität Heidelberg Heidelberg = Heidelberg University, University Hospital Mannheim, Boehringer Ingelheim AB, Stockholm, Boehringer Ingelheim Pharma GmbH & Co. KG, Baylor Heart and Vascular Institute, Baylor University Medical Center, Imperial College London, The EMPEROR‐Reduced trial was funded by the Boehringer Ingelheim & Eli Lilly and Company.

المصدر: ISSN: 2047-9980 ; Journal of the American Heart Association ; https://hal.univ-lorraine.fr/hal-03918171Test ; Journal of the American Heart Association, 2023, 12 (1), pp.e027652. ⟨10.1161/JAHA.122.027652⟩.

مصطلحات موضوعية: [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system

الوصف: International audience ; Background Outcomes and treatment effects of therapy may vary according to the cause of heart failure (HF). Methods and Results In this post hoc analysis of the EMPEROR‐Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction) trial, the effect of empagliflozin on cardiovascular and renal outcomes was assessed according to the cause of HF. The cause of HF was investigator reported and stratified as ischemic or nonischemic. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs. Of the 3730 patients enrolled, 1929 (51.7%) had ischemic cause. In the placebo arm, patients with ischemic cause of HF did not have a significantly higher risk of cardiovascular mortality (HR, 1.21 [95% CI, 0.90–1.63]) and hospitalization for HF (HR, 0.90 [95% CI, 0.72–1.12]) compared with nonischemic cause. Empagliflozin compared with placebo significantly reduced the risk of cardiovascular death or hospitalization for HF in patients with ischemic and nonischemic cause (HR, 0.82 [95% CI, 0.68–0.99] for ischemic and HR, 0.67 [95% CI, 0.55–0.82] for nonischemic cause; P interaction=0.15). The benefit of empagliflozin on HF hospitalization, the renal composite end point, estimated glomerular filtration slope changes, and health status scores were also consistent in both groups without treatment by cause modification. Conclusions Empagliflozin offers cardiovascular and renal benefits in patients with heart failure with reduced ejection fraction regardless of the cause of HF. Registration URL: https://www.clinicaltrials.govTest ; Unique identifier: NCT03057977.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/36565199; hal-03918171; https://hal.univ-lorraine.fr/hal-03918171Test; https://hal.univ-lorraine.fr/hal-03918171/documentTest; https://hal.univ-lorraine.fr/hal-03918171/file/JAHA.122.027652.pdfTest; PUBMED: 36565199

الإتاحة: https://doi.org/10.1161/JAHA.122.027652Test
https://hal.univ-lorraine.fr/hal-03918171Test
https://hal.univ-lorraine.fr/hal-03918171/documentTest
https://hal.univ-lorraine.fr/hal-03918171/file/JAHA.122.027652.pdfTest

المؤلفون: Butler, Javed, Usman, Muhammad Shariq, Filippatos, Gerasimos, Ferreira, João Pedro, Böhm, Michael, Brueckmann, Martina, Januzzi, James, L, Kaul, Sanjay, Piña, Ileana, L, Ponikowski, Piotr, Senni, Michele, Sumin, Mikhail, Verma, Subodh, Zaremba-Pechmann, Liliana, Pocock, Stuart, J, Packer, Milton, Anker, Stefan

المساهمون: Baylor Scott and White Research Institute Dallas, TX, USA, University of Mississippi Medical Center (UMMC), “Attikon” University Hospital, National and Kapodistrian University of Athens (NKUA), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique plurithématique Pierre Drouin Nancy (CIC-P), Centre d'investigation clinique Nancy (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists Vandoeuvre-les-Nancy (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu Nancy, French-Clinical Research Infrastructure Network - F-CRIN Paris (Cardiovascular & Renal Clinical Trialists - CRCT ), Saarland University Hospital (UKS), Universität des Saarlandes Saarbrücken, Boehringer Ingelheim International GmbH, Medizinische Fakultät Mannheim, Universität Heidelberg Heidelberg = Heidelberg University, Massachusetts General Hospital Boston, MA, USA, Harvard Medical School Boston (HMS), Baim Institute for Clinical Research Boston MA, Cedars-Sinai Medical Center, Central Michigan University (CMU), Wrocław Medical University, Azienda Ospedaliera Ospedale Papa Giovanni XXIII Bergamo, Italy, St. Michael's Hospital, University of Toronto, Elderbrook Solutions GmbH on behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, London School of Hygiene and Tropical Medicine (LSHTM), Imperial College London, Baylor Heart and Vascular Institute, Baylor University Medical Center, Berlin-Brandenburg Center for Regenerative Medicine Berlin, Germany (BCRT), Charité - UniversitätsMedizin = Charité - University Hospital Berlin, German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), The EMPEROR-Preserved trial was funded by the Boehringer Ingelheim and Eli Lilly and Company Diabetes Alliance

المصدر: ISSN: 2380-6583.

مصطلحات موضوعية: [SDV]Life Sciences [q-bio]

الوصف: International audience ; Importance The diuretic effect of sodium-glucose cotransporter 2 inhibitors may result in interaction with background diuretic therapy in patients with heart failure and preserved ejection fraction (HFpEF). Objective To assess the safety and efficacy of empagliflozin in combination with background diuretic therapy and the association of empagliflozin with the need for conventional diuretics. Design, Setting, and Participants This was a post hoc analysis of the Empagliflozin Outcome Trial in Patients with Chronic Heart Failure with Preserved Ejection Fraction (EMPEROR-Preserved). EMPEROR-Preserved was a phase 3, randomized, placebo-controlled, double-blind clinical trial conducted from March 2017 to April 2021. Patients with class II to IV heart failure and left ventricular ejection fraction greater than 40% were included. Of 5988 patients enrolled, 5815 (97.1%) had baseline data on diuretic use and were included in this analysis, which was conducted from November 2021 to August 2022. Interventions Participants in EMPEROR-Preserved were randomized to empagliflozin or placebo. In this analysis, participants were divided into 4 subgroups: no diuretics and furosemide-equivalent diuretic dose of less than 40 mg, 40 mg, and greater than 40 mg at baseline. Main Outcomes and Measures The main outcomes of interest were first hospitalization for heart failure (HHF) or cardiovascular death (CV death) and its components. Association of empagliflozin vs placebo with outcomes by baseline diuretic status (no diuretic vs any dose) and dose (no diuretic, <40 mg, 40 mg, and > 40mg) was assessed. Association of empagliflozin use with changes in diuretic therapy was also studied. Results Among 5815 patients (mean [SD] age, 71.9 [9.4] years; 2594 [44.6%] female) with known baseline diuretic use, 1179 (20.3%) were not taking diuretics, 1725 (29.7%) were taking less than 40 mg, 1772 (30.5%) were taking 40 mg, and 1139 (19.6%) were taking greater than 40 mg. In the placebo arm, patients with higher ...

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/37223933; hal-04105856; https://hal.univ-lorraine.fr/hal-04105856Test; https://hal.univ-lorraine.fr/hal-04105856/documentTest; https://hal.univ-lorraine.fr/hal-04105856/file/jamacardiology_butler_2023_oi_230021_1684420487.3776.pdfTest; PUBMED: 37223933; PUBMEDCENTRAL: PMC10209829

الإتاحة: https://doi.org/10.1001/jamacardio.2023.1090Test
https://hal.univ-lorraine.fr/hal-04105856Test
https://hal.univ-lorraine.fr/hal-04105856/documentTest
https://hal.univ-lorraine.fr/hal-04105856/file/jamacardiology_butler_2023_oi_230021_1684420487.3776.pdfTest

المؤلفون: Khan, Muhammad Shahzeb, Anker, Stefan, D, Filippatos, Gerasimos, Ferreira, João Pedro, Pocock, Stuart, J, Januzzi, James, L, Chopra, Vijay, K, Piña, Ileana, L, Böhm, Michael, Ponikowski, Piotr, Verma, Subodh, Brueckmann, Martina, Vedin, Ola, Peil, Barbara, Zannad, Faiez, Packer, Milton, Butler, Javed

المساهمون: Duke University Durham, Berlin-Brandenburg Center for Regenerative Medicine Berlin, Germany (BCRT), Charité - UniversitätsMedizin = Charité - University Hospital Berlin, German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), National and Kapodistrian University of Athens (NKUA), “Attikon” University Hospital, Centre d'investigation clinique plurithématique Pierre Drouin Nancy (CIC-P), Centre d'investigation clinique Nancy (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists Vandoeuvre-les-Nancy (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu Nancy, French-Clinical Research Infrastructure Network - F-CRIN Paris (Cardiovascular & Renal Clinical Trialists - CRCT ), Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto, Heart Failure Clinic, Centro Hospitalar de Vila Nova de Gaia/Espinho, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), London School of Hygiene and Tropical Medicine (LSHTM), Massachusetts General Hospital Boston, Harvard Medical School Boston (HMS), Department of Cardiology, Medanta, Gurgaon, Haryana, Jefferson (Philadelphia University + Thomas Jefferson University), Saarland University Saarbrücken, Wrocław Medical University, St. Michael's Hospital, University of Toronto, Boehringer Ingelheim International GmbH, Universität Heidelberg Heidelberg = Heidelberg University, Boehringer Ingelheim AB, Stockholm, Baylor College of Medecine, Imperial College London, Baylor Scott & White Research Institute (BSWRI), University of Southern Mississippi (USM), The EMPEROR-Reduced trial was funded by the Boehringer Ingelheim & Eli Lilly and Company Diabetes Alliance.

المصدر: ISSN: 1071-9164 ; Journal of Cardiac Failure ; https://hal.univ-lorraine.fr/hal-04192638Test ; Journal of Cardiac Failure, 2023, 29 (10), pp.1345-1354. ⟨10.1016/j.cardfail.2023.06.024⟩.

مصطلحات موضوعية: [SDV]Life Sciences [q-bio]

الوصف: Background: The presence of ischemic heart disease impacts prognosis in patients affected by heart failure and reduced ejection fraction (HFrEF). It is not well known how the extent of vascular disease impacts prognoses and responses to therapy in this setting.Methods: In this post hoc analysis of the EMPEROR-Reduced trial, outcomes and the effects of empagliflozin, were assessed in study participants according to the extent (none vs mono1 vs poly [≥ 2] vascular bed) of vascular disease. Vascular disease was defined as investigator-reported coronary artery disease (CAD), peripheral artery disease (PAD) and cerebrovascular disease at baseline. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Incidence rates are presented per 100 person-years (py) of follow-up.Results: Of the 3730 study participants enrolled, 1324 (35.5%) had no vascular disease, 1879 (50.4%) had monovascular disease, and 527 (14.1%) had polyvascular disease. Participants with polyvascular disease tended to be older and male and to have had histories of hypertension, diabetes and smoking. In the placebo arm, a significantly higher risk for cardiovascular death existed in those with polyvascular disease (HR 1.57, 95% CI1.02, 2.44, compared to those with no vascular disease). In adjusted analysis, the benefit of empagliflozin in cardiovascular death or hospitalization due to HF, HF hospitalization, cardiovascular death, renal composite endpoint, estimated glomerular filtration slope changes, and health status scores were seen across the 3 groups (interaction P > 0.05 for all) but were attenuated in those with polyvascular disease. Adverse events were higher in those with polyvascular disease, but no major differences were noted between empagliflozin or placebo assignment in the 3 groups.Conclusion: In patients with HFrEF, the extent of vascular disease is associated with the risk for adverse cardiovascular outcomes. Empagliflozin offers cardiovascular and renal benefits in HFrEF across ...

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/37558088; hal-04192638; https://hal.univ-lorraine.fr/hal-04192638Test; https://hal.univ-lorraine.fr/hal-04192638/documentTest; https://hal.univ-lorraine.fr/hal-04192638/file/1-s2.0-S1071916423002750-main.pdfTest; PUBMED: 37558088

الإتاحة: https://doi.org/10.1016/j.cardfail.2023.06.024Test
https://hal.univ-lorraine.fr/hal-04192638Test
https://hal.univ-lorraine.fr/hal-04192638/documentTest
https://hal.univ-lorraine.fr/hal-04192638/file/1-s2.0-S1071916423002750-main.pdfTest

المؤلفون: Siddiqi, Tariq Jamal, Anker, Stefan, D, Filippatos, Gerasimos, Ferreira, João Pedro, Pocock, Stuart, J, Böhm, Michael, Brueckmann, Martina, Chopra, Vijay, K, Iwata, Tomoko, Januzzi, James, L, Piña, Ileana, L., Ponikowski, Piotr, Senni, Michele, Vedin, Ola, Verma, Subodh, Zhang, Yuhui, Zannad, Faiez, Packer, Milton, Butler, Javed

المساهمون: University of Mississippi Medical Center (UMMC), Berlin-Brandenburg Center for Regenerative Therapies Berlin, Germany, Charité - UniversitätsMedizin = Charité - University Hospital Berlin, German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), National and Kapodistrian University of Athens (NKUA), “Attikon” University Hospital, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique plurithématique Pierre Drouin Nancy (CIC-P), Centre d'investigation clinique Nancy (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists Vandoeuvre-les-Nancy (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu Nancy, French-Clinical Research Infrastructure Network - F-CRIN Paris (Cardiovascular & Renal Clinical Trialists - CRCT ), Heart Failure Clinic, Centro Hospitalar de Vila Nova de Gaia/Espinho, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto, London School of Hygiene and Tropical Medicine (LSHTM), Saarland University Saarbrücken, Saarland University Hospital (UKS), Boehringer Ingelheim International GmbH, University of Heidelberg, Medical Faculty, Max Super Speciality Hospital, Boehringer Ingelheim Pharma GmbH & Co. KG, Massachusetts General Hospital Boston, Baim Institute for Clinical Research Boston MA, Central Michigan University (CMU), Wrocław Medical University, Azienda Ospedaliera Ospedale Papa Giovanni XXIII Bergamo, Italy, Boehringer Ingelheim AB, Stockholm, University of Toronto, St. Michael's Hospital, Peking Union Medical College Hospital Beijing (PUMCH), China Academy of Chinese Medical Sciences, Imperial College London, Baylor Scott & White Research Institute (BSWRI), The EMPEROR-Preserved trial (NCT03057951) was funded by the Boehringer Ingelheim and Eli Lilly and Company Diabetes Alliance.

المصدر: ISSN: 1388-9842 ; European Journal of Heart Failure ; https://hal.univ-lorraine.fr/hal-04106809Test ; European Journal of Heart Failure, 2023, ⟨10.1002/ejhf.2831⟩.

مصطلحات موضوعية: Empagliflozin, Heart failure with preserved ejection fraction, Kansas City Cardiomyopathy, Questionnaire, [SDV]Life Sciences [q-bio]

الوصف: International audience ; Aims: There are limited data on health status and changes in it over time across major subgroups of patients with heart failure and preserved ejection fraction (HFpEF), including ejection fraction spectrum, age, sex, region, body mass index (BMI), and comorbidities including diabetes, chronic kidney disease (CKD), anaemia, and atrial fibrillation/flutter.Methods and results: In the EMPEROR-Preserved trial, the Kansas City Cardiomyopathy Questionnaire (KCCQ) was assessed at baseline, 12, 32 and 52 weeks. Determinants of baseline KCCQ score and change over time, and the impact of empagliflozin on KCCQ scores were studied in specified subgroups. A Cox model was used to assess the association between 5- and 10-point increase and 5-point decrease in KCCQ score from baseline to week 12 and later outcomes. Among 2979 participants in the placebo arm, mean KCCQ clinical summary score (CSS) was 70.7 (20.8). Older age, female sex, BMI, anaemia, and a history of diabetes, and CKD were associated with worse scores. KCCQ-CSS score improved during follow-up; patients with atrial fibrillation/flutter at enrollment (p trend = 0.014) and CKD (p trend < 0.001) had less improvement. A 5-point increase in KCCQ-CSS at week 12 was associated with lower risk of cardiovascular death or heart failure hospitalization (5%), cardiovascular death (8%), and first heart failure hospitalization (4%) subsequently. A similar trend was seen with KCCQ total symptom score (TSS) and overall summary score (OSS). Empagliflozin improved KCCQ-CSS, -TSS and -OSS scores similarly across subgroups studied except for greater improvement in patients with the highest BMI (p trend = 0.153, 0.08 and 0.078, respectively).Conclusion: Health status in patients with HFpEF is impaired, especially in elderly, women, and those with obesity and comorbidities. Empagliflozin improved health status among all key subgroups studied with a greater effect in obese patients.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/36974746; hal-04106809; https://hal.univ-lorraine.fr/hal-04106809Test; https://hal.univ-lorraine.fr/hal-04106809/documentTest; https://hal.univ-lorraine.fr/hal-04106809/file/European%20J%20of%20Heart%20Fail%20-%202023%20-%20Siddiqi%20-%20Health%20status%20across%20major%20subgroups%20of%20patients%20with%20heart%20failure%20and.pdfTest; PUBMED: 36974746

الإتاحة: https://doi.org/10.1002/ejhf.2831Test
https://hal.univ-lorraine.fr/hal-04106809Test
https://hal.univ-lorraine.fr/hal-04106809/documentTest
https://hal.univ-lorraine.fr/hal-04106809/file/European%20J%20of%20Heart%20Fail%20-%202023%20-%20Siddiqi%20-%20Health%20status%20across%20major%20subgroups%20of%20patients%20with%20heart%20failure%20and.pdfTest

المؤلفون: Ezekowitz, Justin A., McMullan, Ciaran J., Westerhout, Cynthia M., Piña, Ileana L., Lopez-Sendon, Jose, Anstrom, Kevin J., Hernandez, Adrian F., Lam, Carolyn S.P., O'Connor, Christopher M., Pieske, Burkert, Ponikowski, Piotr, Roessig, Lothar, Voors, Adriaan A., Koglin, Joerg, Armstrong, Paul W., Butler, Javed

المصدر: Ezekowitz , J A , McMullan , C J , Westerhout , C M , Piña , I L , Lopez-Sendon , J , Anstrom , K J , Hernandez , A F , Lam , C S P , O'Connor , C M , Pieske , B , Ponikowski , P , Roessig , L , Voors , A A , Koglin , J , Armstrong , P W & Butler , J 2023 , ' Background Medical Therapy and Clinical Outcomes from the VICTORIA Trial ' , Circulation: Heart Failure , vol. 16 , no. 9 , ....

مصطلحات موضوعية: heart failure with reduced ejection fraction, hospitalization, mortality, standard of care, vericiguat

الوصف: BACKGROUND: We examined whether the primary composite outcome (cardiovascular death or heart failure hospitalization) was related to differences in background use and dosing of guideline-directed medical therapy in patients with heart failure with reduced ejection fraction enrolled in VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction), a randomized trial of vericiguat versus placebo. METHODS: We evaluated the adherence to guideline use of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, angiotensin receptor-neprilysin inhibitors, beta-blockers, and mineralocorticoid receptor antagonists. We assessed basic adherence; indication-corrected adherence accounting for guideline indications and contraindications; and dose-corrected adherence (indication-corrected adherence+≥50% of drug dose target). Associations between study treatment and the primary composite outcome according to the adherence to guidelines were assessed using multivariable adjustment; adjusted hazard ratios with 95% CIs and P interaction are reported. RESULTS: Of 5050 patients, 5040 (99.8%) had medication data at baseline. For angiotensin-converting enzyme inhibitor, angiotensin-receptor blockers, and angiotensin receptor-neprilysin inhibitors, basic adherence to guidelines was 87.4%, indication-corrected was 95.7%, and dose-corrected was 50.9%. For beta-blockers, basic adherence was 93.1%, indication-corrected was 96.2%, and dose-corrected was 45.4%. For mineralocorticoid receptor antagonists, basic adherence was 70.3%, indication-corrected was 87.1%, and dose-corrected was 82.2%. For triple therapy (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, or angiotensin receptor-neprilysin inhibitors+beta-blocker+mineralocorticoid receptor antagonist), basic adherence was 59.7%, indication-corrected was 83.3%, and dose-corrected was 25.5%. Using basic or dose-corrected adherence, the treatment effect of vericiguat was consistent across adherence to guidelines ...

وصف الملف: application/pdf

العلاقة: https://research.rug.nl/en/publications/370bea3f-a4b0-4006-83d8-9f8b695f1860Test

الإتاحة: https://doi.org/10.1161/CIRCHEARTFAILURE.123.010599Test
https://hdl.handle.net/11370/370bea3f-a4b0-4006-83d8-9f8b695f1860Test
https://research.rug.nl/en/publications/370bea3f-a4b0-4006-83d8-9f8b695f1860Test
https://pure.rug.nl/ws/files/912717492/Background_Medical_Therapy_and_Clinical_Outcomes_From_the_VICTORIA_Trial.pdfTest
http://www.scopus.com/inward/record.url?scp=85170526165&partnerID=8YFLogxKTest

المؤلفون: Khan, Muhammad Shahzeb, Anker, Stefan D., Friede, Tim, Jankowska, Ewa A., Metra, Marco, Piña, Ileana L., Coats, Andrew J.S., Rosano, Giuseppe, Roubert, Bernard, Goehring, Udo-Michael, Dorigotti, Fabio, Comin-Colet, Josep, van Veldhuisen, Dirk J., Filippatos, Gerasimos S., Ponikowski, Piotr, Butler, Javed

المصدر: Khan , M S , Anker , S D , Friede , T , Jankowska , E A , Metra , M , Piña , I L , Coats , A J S , Rosano , G , Roubert , B , Goehring , U-M , Dorigotti , F , Comin-Colet , J , van Veldhuisen , D J , Filippatos , G S , Ponikowski , P & Butler , J 2023 , ' Minimal Clinically Important Differences in 6-Minute Walk Test in Patients With HFrEF and Iron Deficiency : MCID for 6MWT in patients with HFrEF and ....

مصطلحات موضوعية: 6-minute walk test, Heart failure with reduced ejection fraction, minimal clinically important difference

الوصف: Background: The 6-minute walk test (6MWT) is widely used to measure exercise capacity; however, the magnitude of change that is clinically meaningful for individuals is not well established in heart failure with reduced ejection fraction (HFrEF). Objective: To calculate the minimal clinically important difference (MCID) for change in exercise capacity in the 6MWT in iron-deficient populations with HFrEF. Methods: In this pooled secondary analysis of the FAIR-HF and CONFIRM-HF trials, mean changes in the 6MWT from baseline to weeks 12 and 24 were calculated and calibrated against the Patient Global Assessment (PGA) tool (clinical anchor) to derive MCIDs in improvement and deterioration. Results: Of 760 patients included in the 2 trials, 6MWT and PGA data were available for 680 (89%) and 656 (86%) patients at weeks 12 and 24, respectively. The mean 6MWT distance at baseline was 281 ± 103 meters. There was a modest correlation between changes in 6MWT and PGA from baseline to week 12 (r = 0.31; P < 0.0001) and week 24 (r = 0.43; P < 0.0001). Respective estimates (95% confidence intervals) of MCID in 6MWT at weeks 12 and 24 were 14 meters (5;23) and 15 meters (3;27) for a “little improvement” (vs no change), 20 meters (10;30) and 24 meters (12;36) for moderate improvement vs a “little improvement,”, -11 meters (-32;9.2) and -31 meters (-53;-8) for a “little deterioration” (vs no change), and -84 meters (-144;-24) and -69 meters (-118;-20) for “moderate deterioration” vs a “little deterioration”. Conclusions: The MCID for improvement in exercise capacity in the 6MWT was 14 meters–15 meters in patients with HFrEF and iron deficiency. These MCIDs can aid clinical interpretation of study data.

وصف الملف: application/pdf

العلاقة: https://research.rug.nl/en/publications/1c15072b-185b-4b0d-9e14-8a9da1e9f73bTest

الإتاحة: https://doi.org/10.1016/j.cardfail.2022.10.423Test
https://hdl.handle.net/11370/1c15072b-185b-4b0d-9e14-8a9da1e9f73bTest
https://research.rug.nl/en/publications/1c15072b-185b-4b0d-9e14-8a9da1e9f73bTest
https://pure.rug.nl/ws/files/691487874/Minimal_Clinically_Important_Differences_in_6_Minute_Walk_Test_in_Patients_With_HFrEF_and_Iron_Deficiency.pdfTest