Cardiology News / Recent Literature Review / Third Quarter 2022
Keywords:Cardiology literature, literature review
HCS, 43rd International Congress of Cardiology, Athens, 20-22/10/22
NY Cardiovascular Symposium 2022, New York, NY, USA, 9-11/12/22
AF Symposium, Boston, MA, USA, 2-4/2/2023
ACC Annual Meeting, New Orleans, LA, USA, 4-6/3/23
EHRA Annual Meeting, Barcelona, Spain, 16-18/4/23
Euro PCR 2023, Paris, 16-19/5/2023
HRS Annual Meeting, New Orleans, LA, USA, 19-21/5/23
EMPEROR-Preserved: Empagliflozin Reduced Cardiovascular Disease (CVD) and Heart Failure (HF) Hospitalizations (HFH) and Improved Symptoms Across a Wide Age Range / High age was not Associated with Decreased Efficacy or Intolerability
The relationship of age and empagliflozin effects was evaluated in the EMPEROR-Preserved trial. Patients (N=5,988) were grouped according to their baseline age (<65 years, n = 1,199; 65-74 years, n = 2,214; 75-79 years, n = 1,276; ≥80 years, n = 1,299). The incidence of primary outcomes (CVD or HFH) (P trend = 0.02) and CVD (P trend = 0.003) increased with age. Empagliflozin reduced primary outcomes (P trend = 0.33), first HFH (P trend = 0.22), and first and recurrent HFH (P trend = 0.11) across all age groups with an effect being similar at ≥75 years or >80 years. Empagliflozin improved Kansas City Cardiomyopathy Questionnaire–Clinical Summary Score at week 52 and attenuated the decline of estimated glomerular filtration rate without age interaction. There were no clinically relevant differences in adverse events between empagliflozin and placebo across the age groups. Thus, empagliflozin reduced primary outcomes and first and recurrent HFH and improved symptoms across a broad age spectrum. High age did not reduce efficacy or meaningful intolerability (Bohm M et al, J Am Coll Cardiol 2022;80:1-18).
ARIC Study: Adult Cancer Survivors Have Higher Risk of CVD, Especially HF, Independent of Traditional CV Risk Factors
A prospective community-based study including 12,414 ARIC (Atherosclerosis Risk In Communities) study participants (mean age 54 years, 55% female, 25% Black), of whom 3,250 (25%) had incident cancer over a median 13.6 years, indicated that age-adjusted incidence rates of CVD (per 1,000 person-years) were 23.1 (95% CI: 24.7-29.1) for cancer survivors and 12.0 (95% CI: 11.5-12.4) for subjects without cancer. After adjustment for CV risk factors, cancer survivors had significantly higher risks of CVD (HR: 1.37), HF (HR: 1.52), and stroke (HR: 1.22), but not CAD (HR: 1.11). Breast, lung, colorectal, and hematologic/lymphatic cancers, but not prostate cancer, were significantly associated with CVD risk (Florido R et al, J Am Coll Cardiol 2022;80:22–32).
VALOR-HCM Study: In Obstructive Hypertrophic Cardiomyopathy (OHCM) Patients With Intractable Symptoms, Mavacamten Reduced the Fraction of Patients Meeting Guideline Criteria for Septal Reduction Therapy (SRT) After 16 Weeks
Patients (N=112; age 60 ± 12 years, 51% men, 93% NYHA class III/IV) with left ventricular (LV) outflow tract (LVOT) gradient ≥50 mm Hg at rest/provocation who met guideline criteria for SRT were randomized, double blind, to mavacamten, 5 mg daily, or placebo, titrated up to 15 mg based on LVOT gradient and LV ejection fraction. After 16 weeks, 43 of 56 placebo patients (76.8%) and 10 of 56 mavacamten patients (17.9%) met guideline criteria or underwent SRT, difference (58.9%; P < 0.001). Hierarchical testing of secondary outcomes showed significant differences (P < 0.001) favoring mavacamten, mean differences in post-exercise peak LVOT gradient −37.2 mm Hg; ≥1 NYHA class improvement 41.1%; improvement in patient-reported outcome 9.4 points; and NT-proBNP and cardiac troponin I between-groups geometric mean ratio 0.33 and 0.53 (Desai MY et al, J Am Coll Cardiol 2022;80:95–108)... (excerpt)
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