2022 PRACTICE-CHANGING CLINICAL TRIALS #recap
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~~ a thread ๐งต ~~ ๐
1/ SGLT2 inhibition initiation in the acute hospital setting? This trial showed significant benefit โ REGARDLESS of ejection fraction โ safe, and with incrementally added benefit when started early. EMPULSE Trial, Nature Medicine, 2022 โฅ๏ธ
2/ SGLT2 inhibition for HFpEF? This trial showed SGLT2 inhibitors to have mortality benefit with EF > 40%, regardless of diabetes status. HFpEF represents a population of patients that beyond diuretic use, has historically been difficult to treat. DELIVER Trial, NEJM 2022 โฅ๏ธ
3/ Use of carbonic anhydrase inhibitors in HF? Acetazolamide blocks reabsorption of sodium bicarb in the kidney, leading to โฌ๏ธ natriuresis. This landmark trial showed faster achievement of euvolemia with acetazolamide routinely added. ADVOR Trial, NEJM 2022 โฅ๏ธ
5/ Myosin inhibitors for HCM? Negative inotropes are the standard of care for obstructive HCM. If medical therapy fails, surgical myomectomy can relieve symptoms. This trial showed mavacamten (inhibits actin-myosin binding)to reduce need for surgery. VALOR-HCM Trial, NEJM 2022 โฅ๏ธ
6/ Degree of blood pressure control in pregnancy? This key trial showed strict BP control (<140/90) to improve fetal outcomes over lenient control (<160/105). A message to all us providers treating pregnant patients. CHAP Trial, NEJM 2022 โฅ๏ธ
#cardioOb #womenshealth
#cardioOb #womenshealth
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