Heart Failure
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SGLT2 Inhibitor Plus Aldosterone Antagonist for HFpEF: Safe? Efficacious?
A prospective, open-label, blinded outcome crossover trial of dapagliflozin plus spironolactone vs. dapagliflozin alone in patients with heart failure with preserved or mildly reduced left ventricular ejection fraction resulted in a greater reduction in natriuretic peptides, which was accompanied by a greater decline in kidney function and a rise in serum potassium.
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Does Thoracentesis Speed Recovery from Heart Failure?
An unblinded, multicentered, randomized trial of patients with acute heart failure hospital admissions and significant pleural effusions showed that early thoracentesis, in addition to recommended medical therapy, did not reduce mortality or length of stay, or increase days alive out of the hospital for 90 days. However, it was relatively safe and could be employed in selected persistently symptomatic patients with very large effusions.
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A New Treatment for Heart Failure with Preserved Ejection Fraction
A recent randomized, placebo-controlled trial of the long-acting glucagon-like peptide-1 receptor agonist tirzepatide in patients with heart failure with preserved left ventricular ejection fraction who have obesity, diabetes, and one other weight-related comorbidity has shown that tirzepatide reduces both the symptoms of heart failure as well as the incidence of worsening heart failure events.
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A New Treatment for Heart Failure with Preserved Ejection Fraction
A recent randomized, placebo-controlled trial of the long-acting glucagon-like peptide-1 receptor agonist tirzepatide in patients with heart failure with preserved left ventricular ejection fraction who have obesity, diabetes, and one other weight-related comorbidity has shown that tirzepatide not only reduces the symptoms of heart failure, but reduces the incidence of worsening heart failure events.
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A New Drug for Heart Failure with Preserved Ejection Fraction?
The addition of the nonsteroidal mineralocorticoid receptor antagonist finerenone to standard therapy reduced the incidence of recurrent heart failure and death compared to placebo in patients with heart failure and mildly reduced or preserved left ventricular ejection fraction and was generally well tolerated.
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Are Mineralocorticoid Receptor Antagonists Safe in Heart Failure Patients with Renal Dysfunction?
A post hoc analysis of the RALES and EMPHASIS HF trials has shown that, although treatment of heart failure with reduced left ventricular ejection fraction patients with mineralocorticoid receptor antagonists can cause a significant deterioration in renal function, the benefits outweigh the adverse effects and should not lead to automatic therapy discontinuation.
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Empagliflozin Post-Acute Myocardial Infarction
A prespecified further analysis of the EMPACT-MI trial has shown that patients within two weeks of an acute myocardial infarction who are at risk for heart failure who receive empagliflozin compared to placebo have significantly fewer episodes of heart failure hospitalizations over a median follow-up of 18 months.
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The Hemodynamic Effects of an SGLT2 Inhibitor in Heart Failure with Preserved Ejection Fraction
The authors of a small, placebo-controlled study of 24 weeks of dapagliflozin therapy in patients with heart failure with preserved ejection fraction reported reductions in pulmonary capillary wedge pressure, which may explain the reductions in heart failure hospitalizations or cardiovascular death in larger randomized outcome trials.
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Medical Therapy Before Mitral Valve Edge-to-Edge Repair for Congestive Heart Failure Patients
This study of U.S. registry of mitral transcatheter edge-to-edge repair data revealed a minority of patients undergoing this procedure experience optimized medical therapy, with wide variations across sites.
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The Hemodynamic Effects of an SGLT2 Inhibitor in Heart Failure with Preserved Ejection Fraction
The authors of a small, placebo-controlled study of 24 weeks of dapagliflozin therapy in patients with heart failure with preserved ejection fraction reported reductions in pulmonary capillary wedge pressure, which may explain the reductions in heart failure hospitalizations or cardiovascular death in larger randomized outcome trials.