Blood Hyperosmolarity as a Predictor of Mortality in Patients After Acute Coronary Syndrome: How Dehydration Affects the Prognosis of Our Patients

Serelaxin: A Novel Therapy for Acute Heart Failure with a Range of Hemodynamic and Non-Hemodynamic Actions

“…1In the RELAX-AHF study, serelaxin was associated with a reduced risk of all-cause mortality compared with placebo. This effect was consistent with that observed in the phase II Pre-RELAX-AHF study [14]). Reprinted from Metra [14] copyright (2013), with permission from Elsevier…”

“…However, the effect on all-cause mortality at day 180 with serelaxin was consistent with findings from the phase II pre-RELAX-AHF study (Fig. 1; [14]), which also reported a numerical reduction in 180-day CV and all-cause mortality with serelaxin versus placebo [38]. Of note, the effects of serelaxin on outcomes were similar across subgroups of patients based on pre-specified covariates (age, sex, race, geographic region, estimated glomerular filtration rate [eGFR], time from presentation to randomization, baseline SBP, history of diabetes, atrial fibrillation, ischemic heart disease, cardiac devices, intravenous nitrates at randomization) [39] or ejection fraction (either preserved or reduced) [40].…”

“…2 [14]). In addition, elevations in cardiac troponin T > 20 % from baseline were shown to be associated with increased 180-day mortality [14]. Thus, serelaxin appears to have cardioprotective properties.

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“…2In patients with acute heart failure in the RELAX-AHF study, serelaxin was associated with lower levels of high-sensitivity cardiac troponin levels (hs-cTnT) ( a ) and a reduced incidence of patients with an elevation (≥20 % from baseline) in hs-cTnT ( b ) compared with placebo [14]). Reprinted from Metra [14] (Fig. 3a), copyright (2013), with permission from Elsevier…”

“…This multi-organ damage may accelerate disease progression and impact long-term prognosis. Indeed, many existing and emerging markers of cardiac and extra-cardiac injury confirm that such damage is associated with worse long-term outcomes in AHF [14–30]. Therefore, it appears that treatment strategies for AHF need to address both the immediate hemodynamic abnormalities, giving rise to dyspnea and congestion, as well as prevent organ damage, by addressing the myocardial and extra-cardiac cell injury and remodeling that influence long-term prognosis.…”