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AHA Conference Spotlights HF Management, Statin Acceptance

 


It may not give great results, but GALACTIC-HF promises to add some sparks Virtual Conference of the American Heart Association The session starts on Friday.

Top line results Studies of the novel contractile drug omecamtiv mecarbil in heart failure with reduced ejection fraction (HFrEF) have shown that the combination of cardiovascular death and hospitalization or other emergency treatments for heart failure meets the primary endpoint. I did.

However, the relative 8% reduction and mistakes in the secondary endpoint of cardiovascular death were disappointments suggested by analysts. Limit its future..

This “represents a modest effectiveness in areas that are starting to get a little crowded, so it would be interesting to see how doctors are impressed with the data or not.” , Dr. Deepakbert, MD, Brigam and Women’s Hospital Heart, commented. Boston Vascular Center and Harvard Medical School.

This is the first outcome trial by this agent, “more than visible from top-line results,” said Donald Lloyd-Jones, chair of the conference program at Northwestern University in Chicago and president-elect of AHA. , MD says.

“We are currently in a situation where we have very solid treatments for symptomatological and inpatient heart failure patients who try to reduce the trajectory of advanced heart failure and reduce the associated symptoms.” He said. Today’s MedPage Preview the meeting at a press conference.

This trial and several other trials at the conference “whether new drugs need to be added to the current Big 4 beta blockers, diuretics, mineralocorticoid receptor antagonists, SGLT2 inhibitors. It will tell you. I think you can put an ACE inhibitor there. The question is whether there is room to treat a very sick patient returning to the hospital. “

Two of those other exams AFFIRM-AHF trialLook at the results of iron supplementation for iron deficiency patients hospitalized for acute heart failure, and Invested trialBecause acute viral illnesses often trigger heart failure episodes, we will compare high-dose and standard-dose influenza vaccines for patients with high-risk cardiovascular disease.

On the other side of the spectrum, but perhaps even more influential in everyday practice, is small but powerful. SAMSON trial.. In this N-of-1 trial, patients who discontinued statins due to side effects were randomized, treated with atorvastatin, placebo, or crossover design for a month without treatment, and their feedback was given to individual patients for side effects. The symptom of is a placebo effect, which affects the willingness to take statins for a long time.

“It definitely excited me,” Lloyd Jones said. “How often is the literally minimal trial of 60 patients actually talking to interventionists, general cardiologists, and preventive cardiologists? Because this is a very common problem. , This is very amazing. “

The other highlighted items are:

At the briefing, a series of trials in patients with cardiovascular metabolism was “really revolutionary,” said Dr. Manesh Patel, MD, vice chairman of the Duke University conference in Durham, North Carolina. “These data from these trials will continue to encourage us to think beyond the heart. Patients are very interested in slowing the progression of kidney disease and not undergoing dialysis.”

Of course, the 2020 conference would not be complete without a session on COVID-19. The AHA meeting will feature the first data from the COVID-19 Cardiovascular Disease Registry utilizing the Get With the Guidelines network and a talk by Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.

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