Iron may reduce heart failure or CV death in CKD, but primary CKD clinical outcome trials are needed, especially in non-dialysis CKD, with or without anemia

Our systematic review & meta-analysis - with KDIGO iron/anemia guidelines currently being updated

medrxiv.org/content/10.110…

1/12 - Mystery #1

You are seeing a patient recently diagnosed with heart failure and started on GDMT. You notice that their hemoglobin (HGB) has increased (12 → 13 g/dL) in the intervening weeks.

🤔Which medication is the likely cause of this increase in HGB?

A class of diabetes drug can reduce cardiovascular death in patients with heart and kidney conditions.

New research by the SGLT2i Trialists Consortium including our colleagues, Brendon Neuen, Bruce Neal, Vlado Perkovic and Hiddo Heerspink.

Read more: buff.ly/3TU265k

(1/2) In the aftermath of #ACC24 , it is a good time to review one of the best articles ever written on interpreting clinical trials by Dr. Robert M. Califf :
shorturl.at/qtAK2

Robert Harrington C. Michael Gibson MD Rasha Al-Lamee

Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials - The Lancet thelancet.com/journals/lance…

Javed Butler The Lancet #ACC2024

⚠️ Reducción de MACEs, fundamentalmente mortalidad CV e IC con iSGLT2 en un amplio grupo de pacientes:

📍Enfermedad CV aterosclerótica
📍Diabetes
📍ERC

‼️Metaanalisis SMART-C

AHA Science Soc Esp Cardiología SACardiología Asociación Cardiología Clínica SEC @ICyFA-SEMI

ahajournals.org/doi/10.1161/CI…

#ACC24 #SimPub by Alberto Foà in JACC Journals

Fascinating observation from #PARAGONHF — pts w LVEF above 60% were at *higher* risk of hypotension & *lower* likelihood of benefit w #ARNI sacubitril/valsartan

Reinforces current guidance for pt selection

jacc.org/doi/10.1016/j.…

#CircACC24 #SimPub SGLT2i Trialists Consortium: primary benefit of SGLT2i for MACE driven by reduction in CV death, without clear effect on myocardial infarction or stroke Sid M. Patel TIMI Study Group #AHAJournals ahajournals.org/doi/10.1161/CI…

. Brigham and Women’s Research Clinical Trials Outcomes Center & Friends

Simultaneous Publications with American College of Cardiology #ACC24 across JACC Journals Circulation European Society of Cardiology & JAMA Cardiology

👉🏼 SGLT2i ⬇️ risk of MACE across broad range of pt populations & key subgroups 👉🏼 Benefit primarily driven by ⬇️ CV death, particularly ⬇️ HF death & SCD #SimPub in Circulation from Sid M. Patel Yumi Kang Stephen Wiviott SGLT2 Trialists Consortium #ACC24
ahajournals.org/doi/10.1161/CI…

A #SMART -C Collaborative Meta-Analysis

📌Meta-analysis of 78,607 patients shows #SGLT2i reduce MACE by 9% across patients with DM, #HeartFailure , or #CKD .

📌The benefit for CV death was driven primarily by ⬇️ in HF death and SCD (HR 0.68 [0.46-1.02] and HR 0.86 [0.78-0.95],…

#ACC24 #SimPub in Circulation by Sid M. Patel & #SMARTc investigators

Massive effort evaluating 78,607 patients across 11 late-phase trials in diabetes, CKD, & HF providing definitive evidence of the effects of #SGLT2i on #MACE

ahajournals.org/doi/10.1161/CI…

New SMART-C data #simpub in Circulation

SGLT2i ⬇️major CV events by 9%, mainly by ⬇️CV death,  no clear effect on MI or stroke

14% ⬇️CV death driven by heart failure & sudden cardiac death

Remarkably consistent benefits across key patient groups

ahajournals.org/doi/10.1161/CI…

#ACC24

Great to be part of this - the first of many more kidney focused collaborations with colleagues & friends at Brigham and Women's Hospital #ACC24

So proud of Safia Chatur, MD on the stellar Young Investigator Award presentation with simultaneous publication in JACC Journals!

Effects of #ARNI in #HF across the Spectrum of Kidney Risk in #PARADIGMHF

jacc.org/doi/10.1016/j.…

Join us tomorrow at #ACC24

Pooled data from the SGLT2i Consortium (SMART-C) on the effects of SGLT2i on major CV events & cause-specific cardiovascular mortality in major patient groups (including with & without prior MI)

Led by Sid M. Patel Stephen Wiviott & TIMI Study Group #ACC24

Dr Sid M. Patel presents his work on SGLT2i and MACE in patients with diabetes at high risk for atherosclerotic cardiovascular disease, heart failure or chronic kidney disease in this SMART-C analysis, in 24 hrs in Hall B4-5 Stephen Wiviott #ACC24

In my view, the 23% & 33% ⬇️ in first & total hospitalised HF w/ SGLT2i post-MI is a welcome finding, consistent w/the totality of the evidence

Difficulty for any trial to demonstrate ⬇️ in all-cause mortality over median F/U 18 months given the standard-of-care in 2024

#ACC24

#CircACC24 #SimPub EMPACT-MI analysis: After acute myocardial infarction with left ventricular dysfunction or congestion, empagliflozin reduces the risk of heart failure hospitalizations #AHAJournals Adrian “WE NEED RCTS!” Hernandez @javedbutler1 ahajournals.org/doi/10.1161/CI…

📣 Save the date! Symposium 0.1 at #ERA24 will focus on
“Late Breaking Clinical Trials I - #FLOW study results”, join our speakers on
📅 May 24, 12:00 - 13:15 (CEST)
Discover our Scientific Programme 👉 bit.ly/3HBmvXf