Feb 5, 2021
Volume, volume, volume may be the answer
As findings from trial after trial provide evidence of the clinical benefit of SGLT2 inhibition in patients with reduced ejection fraction heart failure (HFrEF) DAPA-HF, EMPIRE-HF, EMPEROR-Reduced, there is little convincing left to do about the value of adding SGLT2 inhibitors to the HF armamentarium, as demonstrated by their inclusion in an updated expert decision pathway issued by the American College of Cardiology in early January 2021.
But exactly why these drugs provide these demonstrable benefits is still debatable.
Jesper Jensen, MD, PhD, of Herlev and Gentofte University Hospital, Herlev, Denmark, and University of Copenhagen, Copenhagen, Denmark, and colleagues drilled down into data from a prespecified substudy of EMPIRE-HF (EMPIRE-HF Renal) to investigate the “effects of empagliflozin on estimated extracellular volume, estimated plasma volume, and measured glomerular filtration rate (GFR) in patients with hear
Jan 12, 2021
Consistent benefit regardless of CKD etiology
Once, in the not-too-distant past, one could not scan the latest issue of any top-tier medical journal without finding at least one trial extolling the benefits of statin therapy, which lead many to suggest and not always facetiously that it was time to add statins to the water.
Since late summer 2019 when the results of DAPA-HF were reported at the 2019 European Society of Cardiology Congress in Paris, SGLT2 inhibitors have displaced statins as the pharmaceutical of choice for those who like the “one-drug-fits-all-conditions” approach to the art of medicine.
The latest entry comes from David C. Wheeler, MB, ChB, MD of the George Institute for Global Health in Sydney, Australia, who with his co-investigators offers another look at the findings from DAPA-CKD in
Jan 1, 2021
But if rivaroxaban is ’in’, is DAPT ’out’?
The introduction of direct oral anticoagulants (DOACs) in 2010 significantly changed clinical algorithms for prevention of VTE and stroke, as well as management of atrial fibrillation. In this report, which was initially published March 29, 2020, researchers presented findings that support a role for rivaroxaban in revascularization procedures in patients with PAD. BreakingMED is republishing this report as part of its year end clinical review series.
Findings from a trial of more than 6,564 patients undergoing revascularization procedures for peripheral artery disease are likely to change clinical practice, signaling a death knell for dual antiplatelet therapy while boosting the use of direct oral anticoagulant (DOAC) therapy in these patients.
What Mexico’s response to H1N1 can teach us about coronavirus and future pandemics
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The 2009 A(H1N1) pandemic had devastating economic implications in Mexico, just as COVID-19 is having on the global economy. In 2008, Mexico’s gross domestic product (GDP) grew by 1.14 percent. A year later after the A(H1N1) crisis its GDP growth fell to -5.28 percent. Moreover, the A(H1N1) outbreak coincided with the effects of the 2008 financial crisis, when Mexico lost a significant amount of exports to the United States.
Former President of Mexico Felipe Calderón wrote in his memoirs that government officials feared that the A(H1N1) could have had the lethality of avian influenza: around 60 percent. By early April of that year, Mexico City then with 22 million inhabitants and a population density of approximately 5,900 inhabitants per square kilometer had become the outbreak’s epicenter. A slow response to a virus with those levels of lethality would have been catastrophic.