Clinical Cardiology Alert – September 1, 2022

Are SGLT2 Inhibitors Effective for HFpEF Patients Without Diabetes?

After comparing empagliflozin vs. placebo for patients with heart failure and preserved left ventricular ejection fraction, researchers found no differences in the significant reduction of the primary outcome of cardiovascular death or heart failure hospitalization over 36 months based on whether patients were diabetic.

Predicting the Tolerability of Sacubitril/Valsartan in Advanced Heart Failure

An analysis of the sacubitril/valsartan run-in period for chronic, advanced heart failure patients showed 18% could not tolerate the lowest dose, usually because of hypotension or renal dysfunction. Investigators identified six predictors of non-tolerance, which may help clinicians choose the best candidates.

Provocative Testing with Intracoronary Acetylcholine as Part of Cardiac Catheterization Evaluation

In this systematic review and meta-analysis of invasive coronary provocation testing, intracoronary acetylcholine was found to be a safe procedure, with low rates of major complications.

Clinical Significance of Mitral Annular Calcification

Researchers found mitral annular calcification to be uncommon, and few experience associated moderate to severe mitral stenosis or regurgitation. However, the latter group recorded a high mortality rate over three years follow-up, which was significantly lower in those who underwent valve interventions, even when corrected for younger age, fewer comorbidities.

Appropriate Management of Thoracic Aortic Aneurysms

Among patients with arch and descending thoracic aorta aneurysms followed over a mean 20 months, aneurysm-related mortality was predicted by the size and growth rate of the aneurysms, along with age and sex.