Cardiovascular and non‐renal complications of chronic kidney disease: Managing risk DOI Creative Commons
Peter Rossing, Tine W. Hansen, Thomas Kümler

et al.

Diabetes Obesity and Metabolism, Journal Year: 2024, Volume and Issue: 26(S6), P. 13 - 21

Published: July 9, 2024

Abstract Chronic kidney disease (CKD) currently affects approximately 850 million people globally and is continuing to increase in prevalence as well importance a cause of death. The excess mortality related CKD mostly caused by an cardiovascular disease. This includes atherosclerotic many promoters atherosclerosis, such blood pressure, lipid levels hypercoagulation, are increased with CKD. Diabetes leading contributing the risk CVD, obesity also increasingly prevalent. Management these factors therefore very important CKD, reduce progression. Heart failure more prevalent and, again, shared. concept foundational pillars management heart has been adapted treatment organ‐protective interventions, renin‐angiotensin system blockade, sodium‐glucose cotransporter‐2 inhibition mineralocorticoid receptor antagonism, reducing for reduced ejection fraction, but progression Atrial fibrillation common former. In this review non‐renal complications discussed, along how should be managed. Many new opportunities have demonstrated organ protection, implementation challenge.

Language: Английский

Semaglutide versus placebo in patients with heart failure and mildly reduced or preserved ejection fraction: a pooled analysis of the SELECT, FLOW, STEP-HFpEF, and STEP-HFpEF DM randomised trials DOI
Mikhail Kosiborod, John Deanfield,

Richard Pratley

et al.

The Lancet, Journal Year: 2024, Volume and Issue: 404(10456), P. 949 - 961

Published: Aug. 30, 2024

Language: Английский

Citations

56
Transcatheter Valve Repair in Heart Failure with Moderate to Severe Mitral Regurgitation DOI

Stefan D. Anker,

Tim Friede,

Ralph-Stephan von Bardeleben

et al.

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 31, 2024

BackgroundWhether transcatheter mitral-valve repair improves outcomes in patients with heart failure and functional mitral regurgitation is uncertain.MethodsWe conducted a randomized, controlled trial involving moderate to severe from 30 sites nine countries. The were assigned 1:1 ratio either guideline-recommended medical therapy (device group) or alone (control group). three primary end points the rate of composite first recurrent hospitalization for cardiovascular death during 24 months; change baseline 12 months score on Kansas City Cardiomyopathy Questionnaire–Overall Summary (KCCQ-OS; scores range 0 100, higher indicating better health status).ResultsA total 505 underwent randomization: 250 device group 255 control group. At months, was 37.0 events per 100 patient-years 58.9 (rate ratio, 0.64; 95% confidence interval [CI], 0.48 0.85; P=0.002). 26.9 46.6 0.59; CI, 0.42 0.82; KCCQ-OS increased by mean (±SD) 21.6±26.9 8.0±24.5 (mean difference, 10.9 points; 6.8 15.0; P<0.001). Device-specific safety occurred 4 (1.6%).ConclusionsAmong who received therapy, addition led lower at status than alone. (Funded Abbott Laboratories; RESHAPE-HF2 ClinicalTrials.gov number, NCT02444338.)

Language: Английский

Citations

51
Finerenone in patients with heart failure with mildly reduced or preserved ejection fraction: Rationale and design of the FINEARTS‐HF trial DOI Creative Commons
Muthiah Vaduganathan, Brian Claggett, Carolyn S.P. Lam

et al.

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(6), P. 1324 - 1333

Published: May 14, 2024

ABSTRACT Aim Steroidal mineralocorticoid receptor antagonists (MRAs), spironolactone and eplerenone, are strongly recommended in the treatment of patients with chronic heart failure (HF) reduced left ventricular ejection fraction (LVEF), but balance efficacy safety those higher LVEF has not been well established. Broad use steroidal MRAs further limited part due to concerns around risks hyperkalaemia, gynecomastia, kidney dysfunction. These may be mitigated by unique pharmacological properties non‐steroidal MRA finerenone. The FINEARTS‐HF trial is designed evaluate long‐term selective finerenone among HF mildly or preserved fraction. Methods a global, multicentre, event‐driven randomized evaluating oral versus matching placebo symptomatic ≥40%. Adults (≥40 years) New York Heart Association class II–IV symptoms, ≥40%, evidence structural disease, diuretic for at least previous 30 days were eligible. All required elevated natriuretic peptide levels: sinus rhythm, N‐terminal pro‐B‐type (NT‐proBNP) ≥300 pg/ml (or B‐type [BNP] ≥100 pg/ml) required, measured within (in without recent worsening event) 90 event). Qualifying levels NT‐proBNP BNP tripled if patient was atrial fibrillation screening. Estimated glomerular filtration rate <25 ml/min/1.73 m 2 serum potassium >5.0 mmol/L key exclusion criteria. Patients enrolled irrespective clinical care setting (whether hospitalized, recently ambulatory). primary endpoint composite cardiovascular death total (first recurrent) events. started on 14 September 2020 validly 6001 participants across 37 countries. Approximately 2375 events targeted. Conclusions will determine broad population hospitalized ambulatory Clinical Trial Registration: ClinicalTrials.gov NCT04435626 EudraCT 2020‐000306‐29.

Language: Английский

Citations

32
How to tackle therapeutic inertia in heart failure with reduced ejection fraction. A scientific statement of the Heart Failure Association of the ESC DOI Creative Commons
Gianluigi Savarese, Felix Lindberg, Antonio Cannatà

et al.

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(6), P. 1278 - 1297

Published: May 22, 2024

Abstract Guideline‐directed medical therapy (GDMT) in patients with heart failure and reduced ejection fraction (HFrEF) reduces morbidity mortality, but its implementation is often poor daily clinical practice. Barriers to include organizational factors that might contribute inertia, i.e. avoidance/delay of recommended treatment initiation/optimization. The spectrum strategies be applied foster GDMT wide, involves the set‐up care pathways, tailored drug initiation/optimization increasing chance successful implementation, digital tools/telehealth interventions, educational activities targeting patient/physician awareness, use quality registries. This scientific statement by Heart Failure Association ESC provides an overview current state HFrEF, barriers aims at suggesting a comprehensive framework on how overcome inertia ultimately improve HFrEF based up‐to‐date evidence.

Language: Английский

Citations

17
Cardiovascular toxicities of immune therapies for cancer – a scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Council of Cardio‐Oncology DOI Open Access
Carlo G. Tocchetti, Dimitrios Farmakis, Yvonne Koop

et al.

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(10), P. 2055 - 2076

Published: Aug. 1, 2024

Language: Английский

Citations

16
Rationale and design of the FAIR‐HF2‐DZHK05 trial: Ferric carboxymaltose assessment of morbidity and mortality in patients with iron deficiency and chronic heart failure DOI Creative Commons
Stefan D. Anker, Tim Friede,

Javed Butler

et al.

European Journal of Heart Failure, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 28, 2025

Abstract Aims While it is widely accepted that intravenous (IV) iron improves functional capacity, symptoms, and cardiovascular outcomes in patients with heart failure (HF) reduced ejection fraction (HFrEF) diagnosed deficiency (ID), three recently published outcome trials (AFFIRM‐AHF, IRONMAN HEART‐FID) of IV supplementation HF failed to demonstrate a significant benefit on their respective primary endpoints. Dosing after the initial correction baseline ID – by design or as result trial circumstances was relatively low (i.e. <500 mg/year). The objective FAIR‐HF2 evaluate treatment effect ferric carboxymaltose (FCM) compared placebo ambulatory HFrEF using higher dose during follow‐up >1000 second study create prospective evidence for fulfilling new definition HF, i.e. those transferrin saturation <20%. Methods an investigator‐initiated, multicentre, randomized, double‐blind, placebo‐controlled has recruited 1105 chronic left ventricular ≤45% concomitant ID, defined serum ferritin <100 ng/ml 100–299 Patients were consented randomized receive either FCM (treatment) saline (placebo). During estimated median over 2 years, underwent repletion maintenance phase, up 2000 mg, followed 500 mg every 4 months unless stop criteria haemoglobin >16 mg/dl >800 are met repeat visits. will hypotheses: (i) time first event death hospitalization (ii) rate total (first recurrent) hospitalizations (both analysed full population), (iii) <20% at baseline. familywise type I error across endpoint hypotheses be controlled Hochberg procedure (alpha 0.05). Conclusion efficacy improving utilizing more aggressive approach towards ensuring prevention transitional targets have been met.

Language: Английский

Citations

2
Clinical management and therapeutic optimization of patients with heart failure with reduced ejection fraction and low blood pressure. A clinical consensus statement of the Heart Failure Association (HFA) of the ESC DOI Open Access
Hadi Skouri, Nicolas Girerd, Luca Monzo

et al.

European Journal of Heart Failure, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 26, 2025

Language: Английский

Citations

2
Contemporary guideline‐directed medical therapy in de novo, chronic, and worsening heart failure patients: First data from the TITRATE‐HF study DOI Creative Commons
Jishnu Malgie,

Mariëlle I. Wilde,

Pascal R.D. Clephas

et al.

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: 26(7), P. 1549 - 1560

Published: May 12, 2024

Abstract Aims Despite clear guideline recommendations for initiating four drug classes in all patients with heart failure (HF) reduced ejection fraction (HFrEF) and the availability of rapid titration schemes, information on real‐world implementation lags behind. Closely following 2021 ESC HF guidelines 2023 focused update, TITRATE‐HF study started to prospectively investigate use, sequencing, guideline‐directed medical therapy (GDMT) patients, including identification barriers. Methods results is an ongoing long‐term registry conducted Netherlands. Overall, 4288 from 48 hospitals were included. Among these 1732 presented de novo, 2240 chronic, 316 worsening HF. The median age was 71 years (interquartile range [IQR] 63–78), 29% female, 35% (IQR 25–40). In total, 44% chronic HFrEF prescribed quadruple therapy. However, only 1% achieved target dose classes. addition, more often treated a dedicated outpatient clinic as compared general cardiology clinic. each GDMT class, 19% 36% non‐use related side‐effects, intolerances, or contraindications. novo cohort, 49% already used one other indications than Conclusion This first analysis reports relatively high use contemporary while still showing room improvement regarding Importantly, suboptimal, reasons remaining unclear. underscores urgency further optimization strategies within management.

Language: Английский

Citations

11
European Society of Cardiology quality indicators update for the care and outcomes of adults with heart failure. The Heart Failure Association of the ESC DOI Creative Commons
Amr Abdin, Chris Wilkinson, Suleman Aktaa

et al.

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: unknown

Published: July 12, 2024

ABSTRACT Aims To update the European Society of Cardiology (ESC) quality indicators (QIs) for evaluation care and outcomes adults with heart failure. Methods results The Working Group comprised experts in failure including members ESC Clinical Practice Guidelines Task Force failure, Heart Failure Association, a patient representative. We followed methodology QI development. 2023 focused guideline was reviewed to assess suitability recommendations strongest association benefit harm against criteria QIs. All new proposed QIs were individually graded by each panellist via online questionnaires both validity feasibility. existing also underwent voting ‘keep’, ‘remove’ or ‘modify’. Five domains management identified: (1) structural QIs, (2) assessment, (3) initial treatment, (4) therapy optimization, (5) health‐related life. In total, 14 ‘main’ 3 ‘secondary’ selected across five domains. Conclusion This document provides an previously published ensure that these measures are aligned contemporary evidence. may be used quantify adherence clinical practice as recommended guidelines improve patients

Language: Английский

Citations

8
Implementation of guideline‐recommended therapies in heart failure with reduced ejection fraction according to heart failure duration: An analysis of 55 581 patients from the Swedish Heart Failure (SwedeHF) Registry DOI Creative Commons
Angiza Shahim, Cecilia Linde, Gianluigi Savarese

et al.

European Journal of Heart Failure, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 9, 2025

Abstract Aims Guidelines recommend immediate initiation of all four class I guideline‐directed medical therapies, renin–angiotensin system inhibitors (RASI) or angiotensin receptor–neprilysin (ARNI), beta‐blockers, mineralocorticoid receptor antagonists (MRA) and sodium–glucose cotransporter 2 (SGLT2i) following the diagnosis heart failure (HF) with reduced ejection fraction (HFrEF). The extent to which this occurs in new‐onset HFrEF is unclear. We assessed guideline‐recommended therapies during first year a diagnosis. Methods results Swedish HF Registry was linked additional national registries. In patients (ejection <40%), clinical characteristics treatment from when they were available recommended guidelines according time (<3, 3 <6, 6–12 >12 months). Of 55 581 enrolled between 2000 2021, 54%, 5.8%, 4.8% 36% had an duration <3, months, respectively. Patients shorter younger, lower New York Heart Association fewer cardiovascular comorbidities. Within <6 months diagnosis, 93%, 92%, 90% 89% on RASI ARNI, 9.8%, 17%, 19% 22% ARNI alone, 35%, 43%, 44% 46% MRA, 92% 91% 26%, 30%, 28% SGLT2i, Additionally, 18% received cardiac resynchronization therapy/implantable cardioverter‐defibrillator after Conclusions Most beta‐blockers Use MRA SGLT2i limited, both early later periods. Our findings suggest that strategies improve use remain urgently needed.

Language: Английский

Citations

1