Late Breaking Science from Heart Failure Association Discoveries 2020

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The Heart Failure Association’s online event called HFA Discoveries just started and I tried to keep up but it was way too late for me. The live streaming was scheduled for 17:00 CEST which translates to 23:00 Philippine Time. I was able to keep up for the session entitled “Late-Breaking Science Session 1 – Clinical Trial Update,” and then “netlag” got the best of me.

First up, a substudy of the VICTORIA trial which looked at the echocardiographic parameters of patients with heart failure with reduced ejection fraction. One group in the trial received the guanylate cyclase stimulator Vericiguat on top of optimal medical therapy; the other group received a placebo.

In both groups, echo parameters — namely left ventricular ejection fraction and end systolic volume index — improved from baseline to 8 months. This underscores that our current guideline-based treatment for HFrEF is actually pretty good. In the context of echocardiographic parameters, Vericiguat added no significant benefit. Now the main study of VICTORIA showed a significant lowering of cardiovascular death and hospitalization from heart failure in those taking Vericiguat, so it is important to separate mechanistic endpoints from clinical ones.

Next up was a post hoc analysis of DAPA HF looking at diuretic use.

This post hoc analysis showed that mean diuretic dose did not differ significantly between the Dapagliflozin group and the placebo group. This suggests that the cardiovascular benefit seen in those taking an SGLT2 inhibitor is independent of diuresis. It also suggests that maintaining the usual diuretic dose in those taking Dapagliflozin is safe.

Last study for presentation involved the novel transthyretin stabilizer Tafamidis in Transthyretin amyloid cardiomyopathy.

Intake of Tafamidis lead to decreases in all-cause mortality and cardiovascular-related hospitalizations and lower rates of decline in functional capacity.

I really wanted to stay up for “Late-Breaking Science Session 2 – Registries” but middle age is a bummer. I’ll have more once they make the sessions available on-demand.

Related Links

VICTORIA Trial. N Engl J Med 2020; 382:1883-1893
DOI: 10.1056/NEJMoa1915928

DAPA HF. N Engl J Med 2019; 381:1995-2008
DOI: 10.1056/NEJMoa1911303.

ATTR-ACT Trial. N Engl J Med 2018; 379:1007-1016
DOI: 10.1056/NEJMoa1805689

Published by Dr. Mic

Cardiologist / Cardiac Electrophysiologist

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