Heart failure drug treatment: the fantastic four

Bauersachs, Johann

doi:10.1093/eurheartj/ehaa1012

Cited by 173 publications

(151 citation statements)

References 16 publications

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“…Whether sotagliflozin constitutes as just an exception or whether these results were based on differences in the study population remains unclear. However, current data support the combined administration of these drug classes in patients with HF ( 62 ).…”

Section: Discussionmentioning

confidence: 91%

Cardiovascular Outcome in Patients Treated With SGLT2 Inhibitors for Heart Failure: A Meta-Analysis

Gager

Gelbenegger

Jilma

et al. 2021

Front. Cardiovasc. Med.

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Background: Sodium–glucose co-transporter 2 (SGLT2) inhibitors are an emerging class of glucose-lowering drugs that have become increasingly relevant for the treatment and prevention of heart failure (HF). Therefore, we aimed to investigate various SGLT2 inhibitors in patients with established HF at baseline and focused on the different types of HF.Methods: An extensive search of PubMed and Web of Science until January 2021 was done. Two reviewers, independently and in duplicate, applied the selection criteria. This meta-analysis was conducted according to the PRISMA guidelines. Data were pooled using a random-effects model. Randomized controlled trials (RCTs) of SGLT2 inhibitors vs. a comparator in patients with HF reporting clinical outcomes were included. The primary efficacy outcome was the composite of hospitalization for HF (HHF) or cardiovascular (CV) mortality. All-cause mortality, CV mortality, and HHF were considered as secondary endpoints. Subgroup analyses involving the status of diabetes, type of HF, administered type of SGLT2 inhibitor, sex, age, body mass index (BMI), estimated glomerular filtration rate (eGFR), cause of HF, and concomitant medication were performed.Results: Seventeen RCTs, comprising a total of 20,749 participants, were included (n = 10,848 treated with SGLT2 inhibitors and n = 9,901 treated with a comparator). Treatment with SGLT2 inhibitors in a HF population was associated with a 27% relative risk reduction (RRR) of HHF or CV mortality [risk ratio (RR) = 0.73, 95% CI = 0.68–0.78], 32% RRR of HHF (RR = 0.68, 95% CI = 0.62–074), 18% RRR of CV mortality (RR = 0.82, 95% CI = 0.73–0.91), and 17% RRR of all-cause mortality (RR = 0.83, 95% CI = 0.75–0.91). The effect of SGLT2 inhibitors on the primary endpoint was consistent among the different gliflozines. The effect of SGLT2 inhibitors on the primary endpoint was independent of underlying diabetes mellitus, age, sex, BMI, renal function, and HF type.Conclusions: SGLT2 inhibitors are associated with improved CV outcomes in patients with HF.

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Section: Discussionmentioning

confidence: 91%

Cardiovascular Outcome in Patients Treated With SGLT2 Inhibitors for Heart Failure: A Meta-Analysis

Gager

Gelbenegger

Jilma

et al. 2021

Front. Cardiovasc. Med.

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“…Preemptively, the patient is treated with standard heart failure therapies until there is a recovery of systolic function, which usually occurs in 1-4 weeks. As such, our patient was treated with the "fantastic four" combination of an angiotensin-receptor, neprilysin inhibitor, beta-blocker, mineralocorticoid receptor antagonist, and sodium-glucose-like type cotransporter inhibitor to derive cardiovascular benefit with respect to mortality and morbidity, including heart failure hospitalizations [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Africanized Honey Bee Sting-Induced Stress-Related Cardiomyopathy: A Bee or Octopus Trap

Seecheran¹,

Ramdin²,

Singh³

et al. 2021

Cureus

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The Africanized honey bee commonly referred to as the "killer bee," is a hybrid of the East African lowland honey bee with various European honey bees. These bees tend to be more hostile as compared to other bee species. Their stings may have devastating clinical sequelae, including cardiovascular, cerebrovascular events, and fatalities. We report the first-in-Caribbean case of a middle-aged woman who experienced stress-related, Takotsubo cardiomyopathy (also known as stress-related cardiomyopathy [SRC]) after being afflicted with innumerable Africanized honey bee stings. Key clinical message: The clinician should be cognizant of Takotsubo's cardiomyopathy as a potential sequela of Hymenoptera envenomation and anaphylaxis.

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“…abciximab to reduce thrombus formation) has greatly reduced mortality following MI [24][25][26] . Current pharmacological therapies 27 for the treatment of HF include inhibitors of the mineralocorticoid receptor (eplerenone 28 ), the sympathetic nervous system 29 , the sodium-glucose cotransporter 2 (SGLT2; dapagliflozin 30 ), the RAAS (ACEi; Enalapril 31 ; angiotensin receptor blocker valsartan), the natriuretic system (neprilysin-inhibitor sacubitril) or a combination of therapies such as sacubitril/valsartan (angiotensin receptor neprilysin inhibitors; ARNIs) that have been shown to be more effective at treating HF over a range of EFs 32 .…”

Section: Current Treatment and Therapies: Opportunities For Translational Innovationmentioning

confidence: 99%

Preclinical models of myocardial infarction: from mechanism to translation

Martin

Macdonald

Elbassioni

et al. 2021

British J Pharmacology

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Approximately 7 million people are affected by acute myocardial infarction (MI) each year, and despite significant therapeutic and diagnostic advancements, MI remains a leading cause of mortality worldwide. Pre-clinical animal models have significantly advanced our understanding of MI and enable the development of therapeutic strategies to combat this debilitating disease. Notably, some drugs currently used to treat MI and heart failure (HF) in patients had initially been studied in pre-clinical animal models. Despite this, pre-clinical models are limited in their ability to fully recapitulate the complexity of MI in humans. The pre-clinical model must be carefully selected to maximise the translational potential of experimental findings. This review describes current experimental models of MI and considers how they have been used to understand drug mechanisms of action (MOA) and support translational medicine development.

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Heart failure drug treatment: the fantastic four

Cited by 173 publications

References 16 publications

Cardiovascular Outcome in Patients Treated With SGLT2 Inhibitors for Heart Failure: A Meta-Analysis

Cardiovascular Outcome in Patients Treated With SGLT2 Inhibitors for Heart Failure: A Meta-Analysis

Africanized Honey Bee Sting-Induced Stress-Related Cardiomyopathy: A Bee or Octopus Trap

Preclinical models of myocardial infarction: from mechanism to translation

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