ESC: European Society of Cardiology

A new study unveiled on day 2 of ESC Congress 2021 showed finerenone, a nonsteroidal mineralocorticoid receptor antagonist, offers benefits to patients with mild to moderate CKD and type 2 diabetes.

Findings from 5 studies presented on day 1 of ESC Congress 2021 indicate that there is still much to be learned on the complex interaction among COVID-19 infection, cardiovascular care, and heart failure.

Sodium glucose co-transporter 2 (SGLT2) inhibitor use in patients with heart failure with preserved ejection fraction (HFpEF) has generated great enthusiasm, noted Rudolf de Boer, MD, PhD, clinical cardiologist and professor of translational cardiology, University Medical Center Groningen, the Netherlands.

EMPEROR-Preserved represents the first trial to show unequivocal benefits of any drug on major heart failure outcomes in patients with heart failure and preserved ejection fraction, the lead investigator said.

The composite end point of cardiovascular death and heart failure hospitalization was reduced by 21%, which is highly statistically significant and clinically meaningful, noted Stefan Anker, MD, PhD, FESC, principal investigator of EMPEROR-Preserved.

The 5-year update could help solidify the role of sodium glucose co-transporter 2 (SGLT2) inhibitors in treating heart failure, years after the first evidence of their effectiveness emerged.

There are incredible data for sodium-glucose co-transporter 2 (SGLT2) inhibitors, and this is a great class of medicines that is vastly underutilized, stated Deepak L. Bhatt, MD, MPH, executive director of interventional cardiovascular programs at Brigham and Women’s Hospital Heart & Vascular Center and professor of medicine at Harvard Medical School.

The lack of approved treatments for heart failure with preserved ejection fraction has represented a significant unmet need for a condition that affects 50% of patients with heart failure, including large subgroups, such as older women.

There will be new ESC heart failure guidelines and presentation of data from EMPEROR-Preserved and EMPEROR-Pooled, noted Rudolf de Boer, MD, PhD, of University Medical Center Groningen, the Netherlands.

Providers need to focus on detecting and treating cardiovascular complications in at-risk patients, and not get lost in the fact they have COVID-19, said Manan Pareek, MD, PhD, FAHA, FESC, an internal medicine hospital resident at the Yale University School of Medicine.

If you change the narrative and package SGLT-2 inhibitors as a form of cardiovascular risk modulation, cardiologists may be more likely to get involved in diabetes management, said Javed Butler, MD, MPH, MBA, chairman for the Department of Medicine at the University of Mississippi.

During the surge of the pandemic in the Northeast, we saw about a 40% reduction in cardiovascular admissions, while there was a higher rate of mortality among patients who came in, said Deepak L. Bhatt, MD, MPH, of Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School.

It is imperative individuals with cardiovascular diseases remain active despite COVID-19 lockdowns, said Antonio Pelliccia, MD, senior consultant and chief of cardiology at the Institute of Sports Medicine and Science, of the Italian National Olympic Committee.

Below are selected abstracts presented at the European Society of Cardiology 2020 Congress, which was held in a virtual format due to the coronavirus disease 2019 pandemic.

The first study of its kind reports that patients should keep taking well-known heart medications.

It's a great time to be a doctor treating patients with heart failure, given the development of 2 fantastic new treatments within the space of 5 years, said John McMurray, MD, FRCP, FESC, professor of medical cardiology in the Institute of Cardiovascular and Medical Sciences at the University of Glasgow.

The new guidelines can help cardiologists better advise patients with CVD on physical activity, said Antonio Pelliccia, MD, senior consultant and chief of cardiology at the Institute of Sports Medicine and Science, of the Italian National Olympic Committee.

A study finds that a partner's participation in a lifestyle change program can be a key to success, especially for weight loss.

It's interesting that we saw such a clear U-shaped mortality curve for serum bicarbonate levels in a patient population where we usually don't think about measuring bicarbonate, said Manan Pareek, MD, PhD, FAHA, FESC, an internal medicine hospital resident at the Yale University School of Medicine.

Having 2 trials that both show benefits of SGLT2 inhibitors in heart failure hospitalizations can only encourage the use of these drugs, said John McMurray, MD, FRCP, FESC, professor of medical cardiology in the Institute of Cardiovascular and Medical Sciences at the University of Glasgow.

Advances in imaging have made assessment of atherosclerosis non-invasive, while the EVAPORATE trial demonstrates how cardiac CT can assist in looking at a host of different therapies, said Matthew Budoff, MD, professor of medicine at the David Geffen School of Medicine at UCLA and investigator at The Lundquist Institute.

Results from the second major renal outcomes trial for an SGLT2 inhibitor affirm the role of the class in preventing renal decline and kidney failure.

The PARALLAX study points to potential benefits from sacubitril/valsartan in heart failure with preserved ejection fraction, which has no approved treatments.

It's very important to take the EMPEROR-Reduced and DAPA-HF trials together as being complementary, said Milton Packer, MD, of Baylor University Medical Center in Dallas and University of Texas Southwestern Medical School.

In this most recent analysis of REDUCE-IT, results show a consistent benefit favoring icosapent ethyl versus placebo irrespective of the actual statin type, said Deepak L. Bhatt, MD, MPH, of Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School.

Early rhythm control was associated with a marked reduction in cardiovascular deaths among at-risk stroke patients, said Paulus Kirchhof, MD, director of the department of cardiology at the University Heart and Vascular Center UKE Hamburg, and professor of cardiovascular medicine at the Institute of Cardiovascular Sciences at the University of Birmingham.

When results from the EMPA-REG OUTCOME trial came out, nobody was expecting empagliflozin to have a particularly robust benefit on heart failure and several questions were raised as a result, said Javed Butler, MD, MPH, MBA, chairman for the Department of Medicine at the University of Mississippi.

Results from the phase 3 EXPLORER-HCM trial show mavacamten may finally offer a therapeutic solution for patients with hypertrophic cardiomyopathy.

A new study shows that empagliflozin, the diabetes drug that set off a market frenzy 5 years ago, is on par with dapagliflozin for certain heart failure patients.

Through EVAPORATE, we've been able to show at 18 months that patients taking icosapent ethyl (Vascepa) have less plaque and that there is some atherosclerosis regression, marking mechanisms of benefit for these patients, said Matthew Budoff, MD, professor of medicine at the David Geffen School of Medicine at UCLA and investigator at The Lundquist Institute.