Articles related to HEART FAILURE (HF)

Explore the potential of technology in enhancing medication adherence among heart failure patients and the need for more robust research in this area.

Despite the demonstrated benefits of the recommended quadruple therapy for heart failure, its cost-effectiveness is highly sensitive to drug pricing, necessitating more thorough scrutiny and potential policy interventions to ensure equitable patient access.

Dive into how the FDA-approved Farxiga is changing the heart failure treatment landscape. Colleagues, let’s dive into a remarkable milestone. Farxiga, known as dapagliflozin, now has FDA approval. This is groundbreaking for heart failure treatment. It applies to all patients, regardless of their left ventricular ejection fraction (LVEF) status. The approval didn’t happen overnight. Let’s talk about the DELIVER trial, a vital part of the process. It involved over 6,000 patients, all over 40. Each had heart failure, LVEF above 40%, and may or may not have had type 2 diabetes. They took either dapagliflozin or a placebo daily, plus their usual therapy. The trial had a clear goal: time to the first composite event. This included CV death, heart failure hospitalization, or an urgent heart failure visit. The goal applied to everyone, including patients with LVEF less than 60%. Fast forward about 2.3 years, the results were significant. Dapagliflozin cut the composite outcome by 18% versus the placebo. Both worsening heart failure and CV death rates dropped in the dapagliflozin group. The best part? These findings were consistent, even in patients with lower LVEF or diabetes. Expanding the picture, let’s consider two trials together: DELIVER and DAPA-HF. Over 22 […]

Key practice-changing points from the latest guidelines: • 1st line therapy is sacubitril plus valsartan, as this combination increases survival and reduces hospitalizations versus ACE inhibitors and ARBs.• ACE inhibitors should be used only in patients who cannot tolerate sacubitril-valsartan, and ARBs used only in those who cannot tolerate either the 1st- or 2nd-line recommended therapies.• Patients whose ejection fraction increases to more than 40% under therapy should continue to receive therapy.

Social isolation and loneliness were linked to a 17% to 19% increased risk of developing incipient heart failure, respectively. The analysis included 464,773 participants from the U.K. Biobank, followed for a median of 12.3 years.

In this commentary, the editor-in-chief of CCJM considers what is known, and what is still mystery about how the heart and kidneys are modified during chronic heart failure, and discusses how much of our therapy remains empiric and experience-based.