Muthu Vaduganathan
@mvaduganathan
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Cardiologist & Trialist @BrighamWomens @harvardmed | AE @JACCJournals | Podcast #DontMissABeat & #HFinFocus | Disclosures:
Cambridge, MA
Joined July 2017
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For decades, the elegant
#RAAS
has been pharmacologically targeted. SARS-CoV-2 hijacks this system in
#COVID19
New
@NEJM
Special Report
@orlyvardeny
@tmmichelangelo
#McMurray
#Pfeffer
@scottdsolomon
Can
#RAAS
be regulated to protect against
#COVID19
?
📎
19
253
534
How do you communicate the expected lifetime benefits of HF therapies?
New data in
@TheLancet
from 3 RCTs (
#EMPHASISHF
#PARADIGMHF
#DAPAHF
) estimate up to *6 years* of survival gains.
Combination ARNI+BB+MRA+SGLT2i = new therapeutic standard in HFrEF.
📎
25
192
378
The
#SGLTi
have likely accrued the most indications of any class across biomedicine in recent regulatory history
FDA approval for 6 drugs
✅ Glycemic control in T2D (5)
✅ CV risk reduction in T2D (3)
✅ HF irrespective of LVEF (3)
✅ CKD with or without T2D (2)
✅ CKD & T2D (2)
9
158
374
🚨
#DELIVER
, the largest trial of
#HFpEF
&
#HFmrEF
(n=6,263), has met its primary endpoint (CV death + worsening HF) extending
#SGLT2i
dapagliflozin benefits to the full spectrum of patients with HF.
Stay tuned for full data presentation!
@scottdsolomon
2
132
368
Sotagliflozin (INPEFA) receives *broad*
@US_FDA
approval based on
#SOLOISTWHF
&
#SCORED
to reduce CV death, HF hosp, & urgent HF visits in either:
HF
or
T2D, CKD, and CV risk factors
A 3rd
#SGLTi
for the indication of HF treatment irrespective of LVEF
8
97
276
Incredibly excited to join the new
@JACCJournals
#JACCHF
Editorial Board under brilliant EiC
@BiykemB
Deputy Editor:
@akshaydesaimd
Assoc Editors:
@yaleHFdoc
@anita_deswal
@paheidenreich
@DrNasrien
#JJVMcMurray
@spinneymd
@MinnowWalsh
1st issue June 27!
44
12
253
#FINEARTSHF
, the largest trial of an MRA in HFpEF, is now fully enrolled!
6⃣0⃣1⃣6⃣ participants
Many kudos to all investigators & pts worldwide.
Will finerenone achieve the holy grail of MR antagonism: better HF outcomes without excessive hyperkalemia?
5
62
242
Contemporary American & European Guidelines for the Management of
#HeartFailure
:
@JACCJournals
#JACCHF
Guideline Comparison
4
96
228
Thrilled to start as an Editor of
@JACCJournals
FIT/Early Career Section w
#CelinaYong
&
@JasonHanMD
Hopeful to continue the strong legacy established by outgoing Editors
@GarimaVSharmaMD
@ShashankSinhaMD
&
@mwcullen
We look forward to working with you.
36
8
199
Remarkable data from
#EMPEROR
@JACCJournals
#SGLT2i
are truly hemodynamically neutral or may even ↑ BP (!) in tenuous pts w HFrEF
"we observed a slight early ↑ in blood pressure in the <110mmHg group, no change in the 110-130mmHg group, and a slight ↓ in the >130mmHg group."
5
65
191
Feeling inspired after discussing the story of SGLT2 inhibitors, “a most remarkable advance”, this afternoon with EB
10
11
188
New from
#EMPAREGOUTCOME
: Empagliflozin Cuts Insulin Need in
#T2D
by 60%
Among 3,633 insulin-naїve T2D+CVD pts, insulin starts required in 16.4% (PBO) & 7.1% (EMPA) over 3y avg f/u
Driven by
#SGLT2i
effects on glycemia +/- insulin secretion/sensitivity?
5
66
183
Withdrawal of
#GDMT
in HF consistently ➡️adverse clinical course⚠️
#ACEi
in HFrEF (
#QuinaprilHeartStudy
)
#SGLT2i
in HF (
#EMPEROR
)
#MRA
in HFmrEF/HFpEF (tested in
#FINEARTS
)
#GDMT
in HFimpEF DCM (
#TREDHF
)
I would be grateful
@kamleshkhunti
@gcfmd
@JavedButler1
@AndrewJSauer
or anyone who can provide the paper which showed stopping
#GDMT
was associated with increased mortality🙏
I need to provide it for informing colleagues & forgot to bookmark when I saw it on this platform🙏
4
2
16
2
72
183
#AHA21
#SimPub
: Latest from
#TRANSLATEHF
#GWTGHF
in
@JCardFail
In-hospital
#SGLT2i
implementation is:
✅ Safe & effective
✅ Guideline-supported
✅ Projected to save ~15K deaths & ~25K 🏥per yr if fully implemented among Medicare beneficiaries
Why wait?
4
57
182
BREAKING: European Medicines Agency
#CHMP
extends indication for
#SGLT2i
dapagliflozin to encompass *all* HF!
“Forxiga is indicated in adults for the treatment of symptomatic chronic HF”
Hats off to
@scottdsolomon
,
#DELIVER
investigators, & all participants. Record speed 👏 👏
1
52
173
New Era of Combination Therapy for CKD+T2D for Kidney & CV Protection? RASi + 3rd gen MRA + SGLT2i
Highly overlapping with disease-modifying therapy for HFrEF (βb + RASi + MRA + SGLT2i)
Lends further support for common "Cardio-Renal-Metabolic" disease models with shared goals.
2
85
169
From Apple Tree Bark to Heart Failure: The Discovery & Study of SGLT-2 Inhibitors
Now published with
@JavedButler1
in
@NatureMedicine
@NatureNews
Ahead of
@AHAMeetings
#AHA19
where we will learn more from the
#DAPAHF
trial
4
64
168
.
@US_FDA
expands approval of
#SGLT2i
dapagliflozin to reduce CV death, HF hosp, & urgent HF visits to all adults w HF regardless of
#LVEF
based on
#DELIVER
.
A 2nd major approval for
#LVEF
>40%. 👏🏾 to vision & leadership by
@scottdsolomon
@UoGHeartFailure
1
49
168
Wow,
#STRONGHF
powerful data published in
@TheLancet
supporting rapid uptitration of
#GDMTWorks
. Many congrats
@AlexMebazaa
& team
HF hosp or death up to day 180 absolute risk difference 8·1% [95% CI 2·9–13·2] & relative risk 0·66; 95% CI 0·50–0·86!
2
59
167
Practical Guide to Prescribing SGLT2 Inhibitors for Cardiologists now online in Feb 2019
@JACCJournals
#JACCHF
Issue
Together with Dr. Orly Vardeny, we address common questions faced by cardiologists in practice when considering SGLT2i initiation
👇🏾
1
82
165
Statistical mastermind
#BrianClaggett
presenting
@BrighamWomens
#CVGR
One of the best clinical trial biostatisticians in the world, yet remains incredibly humble and generous. Privileged to learn from him.
@scottdsolomon
4
29
163
On the heels of
#AHA22
, extremely excited to announce new
@JCardFail
#FocusIssue
on
#CardioRenalMetabolism
guest edited w
@brendonneuen
&
#DrJenniferGreen
.
📰 5 original papers incl 1 RCT
📰 SOA Review
📰
#DCRM
Multispecialty Guidance
📰 Pt Perspective
1
20
60
NOLA with all its charm was hard to leave. Missed a 6AM ✈️after 🥳, but made it back to Boston after a great
@ACCinTouch
#ACC19
Particularly meaningful to again experience the Convocation Ceremony after watching my dad receive
#FACC
in NOLA at
#ACC95
...w/ a young E Braunwald
8
7
161
Are
#SGLT2i
Simply "Smart Diuretics"?
Amounting evidence, including from
#EMPERORReduced
in this issue of
@JACCJournals
, argues against diuresis as a dominant mechanism of benefit.
Packer et al.:
Editorial with
@MkosiborodMD
:
3
67
152
New HF & EP collab in
#EJHF
w
@SunnyVMD
@JagSinghMD
Pre-enrollment
#GDMT
panels are being integrated into new device RCTs. As 4pillar
#GDMT
↓
#SCD
, should
#HeartTeam
concept be extended to
#ICD
decision-making to ensure preimplant
#GDMT
& tailor timing?
4
68
151
P3
#EMPAKIDNEY
RCT stopped early due to efficacy in
#CKD
. Congrats
@willkidney
@Oxford_NDPH
& investigators!
Broad clinical profiles
⭐️1/2 w/o diabetes
⭐️1/2 w/ UACR<300mg/g
⭐️1/4 w/ GN
CKD trials likely to have clearest mortality signal across
#CaReMe
.
2
57
146
Thrilled to share that “Effect of Intensive BP Control on Lifespan in
#SPRINT
” was selected for
#AHA19
Early Career Best Science Award
With Brian Claggett
@spjuraschek
@scottdsolomon
(it’s his bday, wish him if you see him!)
Featured by
@AHAScience
:
26
17
146
New from
#DELIVER
in
@CircAHA
by
@BrighamFellows
#JohnOstrominski
Dapagliflozin and Apparent Treatment-Resistant Hypertension in HF
🔑 Resistant HTN identified in >1 in 10 pts
🔑 SGLT2i consistently ↓ CV events
🔑 SGLT2i modestly ↓ SBP by ≈1-3 mmHg
2
48
146
'eGFR dip' common to many evidence-based
#CKD
Rx
All modern kidney
#GDMT
(
#RASi
#SGLT2i
#nsMRA
) = early & reversible eGFR ↓
Key to limit reactionary discontinuation as early ↓ in
#hyperfiltration
likely key mechanism of long-term kidney protection
#FIDELIODKD
eGFR slopes 👇🏾
4
35
140
*Updated* Practical Considerations for the Use of
#SGLT2i
in HF by Cardiologists
Now out in
@CircHF
led by
@mchonig
& Dr. O Vardeny
Ahead of labeling of dapagliflozin in HF, we discuss unique aspects of its
#implementation
in multi-drug regimens in HF.
3
65
142
New in
@CircAHA
by
#DrAdamson
&
@Kieranfdocherty
in
#DAPAHF
Acute eGFR decline>10% with PBO a/w harm: HR 1.45 95%CI 1.19-1.78
Acute eGFR decline>10% after starting
#SGLT2i
a/w benefit: HR 0.73 95%CI 0.59-0.91
'eGFR dip'=not a reason to discontinue Rx!
4
52
142
#EMPERORPreserved
Top Line 🔥
Empagliflozin ↓ risk of CVd+HF hosp in 5,988 pts HFpEF
Awaiting
#ESC2021
LBCT together w
#EMPERORPooled
(n=9,718) across LVEF spectrum (primary EP of kidney events)
Bravo
@JavedButler1
#StefanAnker
@FaiezZANNAD
@Filippatos
0
46
133
Do you use
#NOACs
to treat AF/VTE or prevent VTE in pts with
#cancer
?
Don't miss an updated primer for cardiologists on RCTs, guidelines, & risk scores
Anticoagulation in Patients With Cancer now out concurrent w/
@ACCinTouch
#ACC19
in
@JACCJournals
👇🏾
3
62
137
#PARADISEMI
ARNI in Acute Myocardial Infarction out in
@NEJM
by Prof Marc Pfeffer et al.
@EldrinL
@gabrielsteg
@OtavioBerwanger
@scottdsolomon
@MajaCikes
@markcpetrie20
@Drroxmehran
@DLMann_MD
@cbgranger
Special congrats
@BrighamFellows
#DrKarolaJering
!
3
42
136
Another win for IV iron in HF! Now with a different iron formulation.
#IRONMAN
now out in
@TheLancet
with
#AHA22
2
40
134
New in
@JACCJournals
w
@JJheart_doc
on intersection of biomarkers &
#SGLT2i
in
#T2D
.
Canagliflozin in
#CANVAS
⤵️hs-cTnT & sST2 out to 6yrs
⤵️HF & kidney outcomes irrespective of baseline biomarkers
⤵️MACE particularly in those w multiple abnormal markers
4
37
130
#FINEARTSHF
Design & Baseline
#HeartFailure2023
LBCT by
@scottdsolomon
The largest trial ever of
#MRA
in established HF
✅ >50% enrolled within 30d of worsening HF event
✅ with & without diabetes
✅ full range of kidney function down to eGFR 25
The war on HF continues! 🔥🔥🔥
1
28
130
*The WATCH-DM Score* to predict incident HF in T2DM
Who should you watch for early consideration of
#SGLT2i
?
Thrilled to share late-breaking science at
#HFSA2019
, now simultaneously pub in
@ADA_Journals
in collab w/
@UTSWNews
@MattSegar
&
@ambarish4786
3
63
123
Perhaps the most important day this year for cardiology:
The largest HFpEF trial to date
#PARAGONHF
by
@scottdsolomon
The largest DM trial to date
#THEMIS
by
@DLBHATTMD
&
@gabrielsteg
The first HF outcomes trial of SGLT2i
#DAPAHF
by McMurray
At the largest CV meeting ever?
mammoth Hotline session planned tomorrow: Themis, Themis-PCI, Paragon, Complete, Dapa-HF... not to be missed !
@DLBHATTMD
#ESCcongress2019
0
9
30
1
35
126
#ACC24
#SimPub
by
@FoaAlberto
in
@JACCJournals
Fascinating observation from
#PARAGONHF
— pts w LVEF above 60% were at *higher* risk of hypotension & *lower* likelihood of benefit w
#ARNI
sacubitril/valsartan
Reinforces current guidance for pt selection
1
37
123
Late Breaking Clinical Trial
#AHA19
by Prof McMurray
DAPA-HF remarkably consistent benefits across baseline HbA1c (never seen a treatment effect spline this flat!)
NO major hypoglycemic events seen in non-diabetic pts w HFrEF in DAPA-HF. Volume depletion comparable to placebo
4
43
120
New
#ACC21
SimPub in
@JACCJournals
from
#TRANSLATEHF
collab led by
@RBPatelMD
Strong risk-treatment paradox in HF & kidney disease, such that pts with the highest mortality are treated with ↓ disease-modifying Rx
Supported by
@AHAScience
&
@AstraZeneca
4
40
122
#IMPLEMENTHF
SimPub
@JACCJournals
!
Virtual care teams for rapid in-hospital
#GDMTWorks
✅ Effective (NNT 5 encounters)
✅ Safe
✅ No ↑ LOS
✅ Consistent in both academic/community settings
Massive
#MGB
collab masterfully led by
@ankeetbhatt
&
@SunnyVMD
5
45
122
Congratulations
#EMPERORPreserved
investigators on the practice-changing RCT & for breaking
#CardioTwitter
Definitive result that clearly differentiates from prior RCTs in magnitude of benefit on CVd+HFH (>20%) aligned with risk ↓ in
#HFrEF
...impressive production for week 1!
0
25
118
Strong rationale for early combo disease-modifying therapy as new SoC
4 drugs: ARNI (superior to ACEi)+B-blockers+MRA+SGLT2i
5 targets: Ang II, neprilysin, sympathetic nervous system, mineralocorticoid, SGLT2
6 additional yrs of life (vs. prior Rx era)
2
40
117
#HFSA2023
@JACCJournals
#SimPub
by
@JavedButler1
&
@MkosiborodMD
presenting new data from
#STEPHFpEF
Editorial by
@BrighamFellows
#JohnOstrominski
GLP-1RA in HF: STEPping Across the Ejection Fraction Divide
#HFSA2023
#JACC
LBCT SimPub: In 529 pts w/ obesity-related
#HFpEF
,
#semaglutide
2.4 mg improved HFpEF outcomes to a similar degree vs placebo across baseline
#LVEF
categories, supporting its use for obesity-related HFpEF regardless of LVEF.
@JavedButler1
1
25
65
3
52
118
New in
@ESC_Journals
#EJHF
by
@kirtipalbhatia
&
@vardhmaan_jain
Prevention of HF events with
#SGLT2i
remarkably consistent (~25-30% ↓) across a broad range of risk in 10 RCTs
Absolute Rx benefits amplified in high-risk pts after worsening HF
@DLBHATTMD
2
35
115
.
@AstraZeneca
Press Release: All Primary & Secondary Endpoints Met in
#DAPACKD
"...significantly reduce[d] the risk of death from any cause in this patient population"
New treatment approach for high-risk CKD including among patients *without* type 2 DM
1
43
114
*New* in
@JAMACardio
The
@US_FDA
recently expanded labeling for sacubitril/valsartan in chronic HF with
#LVEF
"below normal". Leveraging integrated data from
#NHANES
#GWTGHF
#PARAGONHF
, we project the US population implications of this regulatory update.
3
39
114
An EMPA-REG OUTCOME-like moment in obesity medicine!
Wow, wow, wow!
In SELECT trial of patients with obesity (mean BMI 33, n>17,000) & prior atherosclerotic cardiovascular disease (but no diabetes),
GLP-1 agonist semaglutide 2.4mg once-weekly
reduced risk of CV death, heart attack, or stroke (RRR 20%)
32
230
839
3
28
112
The
#DELIVER
team is proud to share 4 new
#SimPub
as
#LBCT
/
#FS
at
#HFSA2022
📰Improved LVEF by
@orlyvardeny
in
@NatureMedicine
(in press)
📰Blood Pressure by
@senthil_selv
in
@JACCJournals
#JACCHF
📰Mode of Death by
@akshaydesaimd
in
@JAMACardio
📰Time to Benefit in
@JAMACardio
#DELIVER
at
#HFSA2022
!
Featuring 5 new original data presentations:
🔥 Improved LVEF
🔥 Blood Pressure
🔥 Mode of Death
🔥 Time to Clinical Benefit
🔥
#TRANSLATEHF
Generalizability to US Practice
@HFSA
@scottdsolomon
@orlyvardeny
@senthil_selv
@akshaydesaimd
@UoGHeartFailure
0
27
106
5
30
111
Effects of
#GDMT
across Kidney Function Spectrum
✅
#BB
: consistent benefit to eGFR 30
✅
#ARNI
: consistent benefit to eGFR 30
✅
#SGLT2i
: consistent benefit to eGFR 20
❌
#SteroidalMRA
: ↓ benefit & worse safety at lower eGFR
New strategies to block MR axis in HF & CKD needed!
3
33
111
How Do
#SGLT2i
Really Work?
Clever mediation analyses embedded in EMPAREG OUTCOME & CANVAS offer clues into candidate mechanistic pathways
@scottdsolomon
#BrianClaggett
& I discuss caveats to their interpretation in
#NewYears
@JACCJournals
#JACCHF
issue
4
43
110
Updated
@US_FDA
dapagliflozin labeling (appropriately) separates eGFR thresholds for initiation for glycemic control (45) & other CV/kidney risk ↓ indications (25)
Initiation not recommended<25, but can be continued if already on Rx until dialysis (where it is contraindicated).
@mvaduganathan
@US_FDA
@RBPatelMD
@gcfmd
@SJGreene_md
@_adevore
@JavedButler1
@MKIttlesonMD
@kejoynt
@scottdsolomon
@orlyvardeny
@jimmcdermott13
Is the eGFR 25 for CKD population or also for the Hf population? Is this the recommendation for starting gfr or when to stop if already on the drug and gfr drops below this level?
1
0
1
2
56
111
New
#PARAGONHF
data
@AHAMeetings
#AHA19
now online in
@JACCJournals
w/
@scottdsolomon
Relative & absolute benefits of sacubitril/valsartan compared with valsartan in HFpEF appear to be amplified when initiated in high-risk window after hospitalization
3
59
109
Next
#HFpEF
Phase III outcomes trial announced evaluating 3rd gen MRA Finerenone. Applying learnings from
#TOPCAT
FINEARTS-HF chaired by
@scottdsolomon
👥5,500 HFpEF (≥40%)
🌐34 countries
💊Finerenone vs PBO
❗️ CVd + total HF events
📆 launch Fall 2020
4
33
109
#DELIVER
, the largest
#HFpEF
trial, now fully enrolled n=6263
✅Dual primary analysis of full cohort & subset w LVEF<60% (split alpha)
✅Hybrid ambulatory & stabilized in-hospital enrollment
✅Urgent HF visits in primary endpoint
Results expected in next yr (target events=1,117)
#DELIVER
trial
👉Dapagliflozin in Heart Failure with Preserved and Mildly Reduced EF
@secardiologia
📂
1
29
90
1
29
106
🔥 The Penalty of "Wait & See" Sequencing Approaches now out in
#EHJ
by Shen et al
Combo Rx is standard of care in
#HFrEF
. New data from 6 pivotal RCT underscore ↓
#TimeToGDMT
& optimizing order may avert 14 deaths & 47 CV events in 1yr (per 1K treated)
1
41
107
#DELIVER
at
#HFSA2022
!
Featuring 5 new original data presentations:
🔥 Improved LVEF
🔥 Blood Pressure
🔥 Mode of Death
🔥 Time to Clinical Benefit
🔥
#TRANSLATEHF
Generalizability to US Practice
@HFSA
@scottdsolomon
@orlyvardeny
@senthil_selv
@akshaydesaimd
@UoGHeartFailure
0
27
106
A Welcome ‘Failure’ of Gliflozins:
#BloodPressure
Reduction in
#HeartFailure
in
@escardio
#EHJ
@Kieranfdocherty
&
@PSJhund
highlight the relative hemodynamical neutrality of
#SGLT2i
in HF, facilitating their ease of use.
Average BP ↓ of just <2-3mmHg!
1
38
105
Finerenone Meets Primary Endpoint in Phase III FIDELIO-DKD Kidney Outcomes Trial in CKD & T2D (n~5,700)
✅ Kidney failure, sustained ↓ in eGFR by 40%, renal death
✅ CV death, MI, stroke, HF hosp
Accelerating progress in few short yrs.
@scottdsolomon
0
40
102
Combination Rx is now standard of care across
#CKM
#CKD
(+T2D)
@CircAHA
RASi+SGLT2i+nsMRA+GLP1RA
#HFrEF
@JACCJournals
#JACCHF
ARNI+BB+MRA+SGLT2i
#HFmrEF
/
#HFpEF
@JACCJournals
#JACCHF
ARNI+MRA+SGLT2i(+/-BB)
1
45
104
As HF care becomes increasingly complex,
@gcfmd
& I are excited to announce the launch of the TRANSLATE-HF Platform, a multi-year collaboration between
@American_Heart
&
@AstraZeneca
, with
@DCRINews
& an all-star Steering Committee.
@AP
Press Release:
2
15
97
Masterclass
@BrighamWomens
Grand Rounds by
@TorBiering
Remarkable breadth of high quality randomized evidence being generated by efficiently leveraging the Danish nationwide registries
The future of clinical trials is here!
1
21
99
And the other shoe drops...
Top-Line
#EMPERORReduced
Trial Positive for Empagliflozin in HFrEF with or without Diabetes
Congrats,
#MiltonPacker
,
#StefanAnker
,
@JavedButler1
@FaiezZANNAD
, & investigators. Full results in
#LBCT
@escardio
session on Aug 29
4
25
97
.
@BrighamResearch
Clinical Trials Outcomes Center
@ACCinTouch
#ACC24
Incredibly proud of this diverse group of talented investigators, featuring
🔥 Young Investigator Award Session
🔥 Highlighted Original Research
🔥 >10 Simultaneous Publications
Excited to see everyone in ATL!
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🚨 Entire Special Issue of
@JACCJournals
now released w updated 2021
#JACCGlobalBurdenCVD
estimates across 21 global regions
@IHME_UW
= *The* Compass for Future
#CV
Health
Top 3⃣ Modifiable
#CV
Targets:
1) ↑ Blood pressure
2) Dietary risk
3) ↑ LDL-c
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Great exchange of ideas with the master of pragmatic trials and
#ImpSci
@TorBiering
& impressive team at
@uni_copenhagen
@Rigshospitalet
.
Excited to continue to build global bridges to design & execute the next generation of trials.
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Final Follow-up of
#SYMPLICITYHTN3
by
@DLBHATTMD
now in
@TheLancet
simultaneous with
#TCT2022
LBCT
Enhanced efficacy in BP control with newer generation
#RDN
coupled with these long-term (>3-year) safety data bolster support of
#RDN
as a treatment option
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#DAPAHF
#DELIVER
Peripheral Artery Disease brilliantly presented by
@JawadHButt
at
#HeartFailure2023
LBCT & simultaneously published in
@escardio
#EHJ
Editorial “Good for your heart and safe for your toes”
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#FIGARODKD
now in
@NEJM
Key role of MR antagonism in
#HFprevention
in "stage B" at-risk pop w albuminuric CKD. Impressively more than half had entirely preserved eGFR but w albuminuria
UACR is a powerful measure of risk, now modifiable w selective MRA!
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#DELIVER
Kidney now
#SimPub
w
@ASNKidney
/
#KidneyWk
LBCT in
@JAMACardio
⭐️Consistent dapa safety & benefit on HF outcomes across eGFR range (down to 20)
⭐️Dapa predictable early eGFR dip & slowed long-term eGFR decline
⭐️Very few kidney composite outcomes
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Efficacy of Neurohormonal Therapies to Prevent Cardiotoxicity in Pts w/ Cancer
Featured in Inaugural Issue
@JACCJournals
#JACCCardioOnc
w/
@Hirji1987
@ambarish4786
Meta-analysis (n=17): ~4% attenuation of LVEF decline, unmet need for large powered RCTs
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⚡️Two therapies for
#HFpEF
to be presented back-to-back at
@US_FDA
CV & Renal Drugs AdComm to close out a tumultuous yr
Dec 15 '20: Sacubitril/Valsartan based on
#PARAGONHF
🔗
Dec 16 '20: Spironolactone based on
#TOPCATAmericas
🔗
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*New* from
#DELIVER
in
@TheLancetEndo
Dapagliflozin in
#HFmrEF
&
#HFpEF
✅ Consistent benefit across glycemic spectrum
✅ Efficacious irrespective of background metformin or insulin
✅ 0 cases of serious hypoglycemia or ketoacidosis in those w/o diabetes
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Treatment of worsening HF is diversifying & often occurs outside a hospital setting
Two studies at
#hfadiscoveries
from
#PARAGONHF
&
#DAPAHF
reinforce prognostic implications of ambulatory worsening HF events, strengthening rationale for their inclusion in health policies & RCTs
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90
.
@JACCJournals
reference pocket cards for contemporary global guideline recommendations for drugs & devices in HF across the LVEF spectrum.🗒️
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Pectus Excavatum and RV Compression in a Young Athlete with Syncope led by
@PennMedicine
CV fellow Alex de Feria, published in
@amjmed
Has anyone pursued chest wall reconstruction surgery in an adult with severe pectus deformities?
@RonBlankstein
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New paper out today in
@JACCJournals
#JACCHF
w/
@ambarish4786
&
@_brendan_
>34M adults w T2D in US alone, ~75% without CVd. Can common biomarkers (
#hsTn
#NTproBNP
#hsCRP
#LVH
) be used in risk stratification to inform cost efficient allocation of
#SGLT2i
?
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