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1. Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial

Author

Wei, Fang-Fei, Pellicori, Pierpaolo, Ferreira, João Pedro, González, Arantxa, Mariottoni, Beatrice, An, De-Wei, Verdonschot, Job A. J., Liu, Chen, Ahmed, Fozia Z., Petutschnigg, Johannes, Rossignol, Patrick, Heymans, Stephane, Cuthbert, Joe, Girerd, Nicolas, Clark, Andrew L., Li, Yan, Nawrot, Tim S., Díez, Javier, Zannad, Faiez, Cleland, John G. F., and Staessen, Jan A.

Published
2024
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9. The Effect of Spironolactone in Patients With Obesity at Risk for Heart Failure: Proteomic Insights from the HOMAGE Trial

Author

Verdonschot, Job A.J., Ferreira, JoÃo Pedro, Pizard, Anne, Pellicori, Pierpaolo, Brunner La Rocca, Hans-Peter, Clark, Andrew L., Cosmi, Franco, Cuthbert, Joe, Girerd, Nicolas, Waring, Olivia J., Henkens, Michiel H.T.M., Mariottoni, Beatrice, Petutschnigg, Johannes, Rossignol, Patrick, Hazebroek, Mark R., Cleland, John G.F., Zannad, Faiez, and Heymans, Stephane R.B.

Published
2022
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11. Urinary proteomic signature of mineralocorticoid receptor antagonism by spironolactone: evidence from the HOMAGE trial.

Author

Yu-Ling Yu, Siwy, Justyna, De-Wei An, González, Arantxa, Hansen, Tine, Latosinska, Agnieszka, Pellicori, Pierpaolo, Ravassa, Susana, Mariottoni, Beatrice, Verdonschot, Job A. J., Ahmed, Fozia, Petutschnigg, Johannes, Rossignol, Patrick, Heymans, Stephane, Cuthbert, Joe J., Girerd, Nicolas, Clark, Andrew L., Verhamme, Peter, Nawrot, Tim S., and Janssens, Stefan

Subjects
HEART failure, MOLECULAR biology, PROTEOMICS, MEDICAL sciences, MINERALOCORTICOID receptors, PEPTIDES, ALDOSTERONE antagonists, SODIUM-glucose cotransporters
Published
2024
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14. The future

Author

Gardner, Roy S., additional, McDonagh, Theresa A., additional, and Clark, Andrew L., additional

Published
2022
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16. Digoxin

Author

Cuthbert, Joseph J., additional and Clark, Andrew L., additional

Published
2022
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24. Proteomic and Mechanistic Analysis of Spironolactone in Patients at Risk for HF

Author

Ferreira, João Pedro, Verdonschot, Job, Wang, Ping, Pizard, Anne, Collier, Timothy, Ahmed, Fozia Z., Brunner-La-Rocca, Hans-Peter, Clark, Andrew L., Cosmi, Franco, Cuthbert, Joe, Díez, Javier, Edelmann, Frank, Girerd, Nicolas, González, Arantxa, Grojean, Stéphanie, Hazebroek, Mark, Khan, Javed, Latini, Roberto, Mamas, Mamas A., Mariottoni, Beatrice, Mujaj, Blerim, Pellicori, Pierpaolo, Petutschnigg, Johannes, Pieske, Burkert, Rossignol, Patrick, Rouet, Philippe, Staessen, Jan A., Cleland, John G.F., Heymans, Stephane, and Zannad, Faiez

Published
2021
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26. A nationwide, population‐based study on specialized care for acute heart failure throughout the COVID‐19 pandemic.

Author

Cannata, Antonio, Mizani, Mehrdad A., Bromage, Daniel I., Piper, Susan E., Hardman, Suzanna M.C., Sudlow, Cathie, de Belder, Mark, Deanfield, John, Gardner, Roy S., Clark, Andrew L., Cleland, John G.F., and McDonagh, Theresa A.

Subjects
COVID-19 pandemic, HEART failure, HEART failure patients, CARDIOVASCULAR disease related mortality, OVERALL survival
Abstract

Aims: The COVID‐19 pandemic disrupted the delivery of care for patients with heart failure (HF), leading to fewer HF hospitalizations and increased mortality. However, nationwide data on quality of care and long‐term outcomes across the pandemic are scarce. Methods and results: We used data from the National Heart Failure Audit (NHFA) linked to national records for hospitalization and deaths. We compared pre‐COVID (2018–2019), COVID (2020), and late/post‐COVID (2021–2022) periods. Data for 227 250 patients admitted to hospital with HF were analysed and grouped according to the admission year and the presence of HF with (HFrEF) or without reduced ejection fraction (non‐HFrEF). The median age at admission was 81 years (interquartile range 72–88), 55% were men (n = 125 975), 87% were of white ethnicity (n = 102 805), and 51% had HFrEF (n = 116 990). In‐hospital management and specialized cardiology care were maintained throughout the pandemic with an increasing percentage of patients discharged on disease‐modifying medications over time (p < 0.001). Long‐term outcomes improved over time (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.90–0.95, p < 0.001), mainly driven by a reduction in cardiovascular death. Receiving specialized cardiology care was associated with better long‐term outcomes both for those who had HFrEF (HR 0.79, 95% CI 0.77–0.82, p < 0.001) and for those who had non‐HFrEF (HR 0.87, 95% CI 0.85–0.90, p < 0.001). Conclusions: Despite the disruption of healthcare systems, the clinical characteristics of patients admitted with HF were similar and the overall standard of care was maintained throughout the pandemic. Long‐term survival of patients hospitalized with HF continued to improve after COVID‐19, especially for HFrEF. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Proteomic profiles of left atrial volume and its influence on response to spironolactone: Findings from the HOMAGE trial and STANISLAS cohort.

Author

Kobayashi, Masatake, Ferreira, João Pedro, Duarte, Kevin, Bresso, Emmanuel, Huttin, Olivier, Bozec, Erwan, Brunner La Rocca, Hans‐Peter, Delles, Christian, Clark, Andrew L., Edelmann, Frank, González, Arantxa, Heymans, Stephane, Pellicori, Pierpaolo, Petutschnigg, Johannes, Verdonschot, Job A.J., Rossignol, Patrick, Cleland, John G.F., Zannad, Faiez, and Girerd, Nicolas

Subjects
BRAIN natriuretic factor, LEFT heart atrium, SOMATOMEDIN, PROTEOMICS, SPIRONOLACTONE
Abstract

Aims: High left ventricular filling pressure increases left atrial volume and causes myocardial fibrosis, which may decrease with spironolactone. We studied clinical and proteomic characteristics associated with left atrial volume indexed by body surface area (LAVi), and whether LAVi influences the response to spironolactone on biomarker expression and clinical variables. Methods and results: In the HOMAGE trial, where people at risk of heart failure were randomized to spironolactone or control, we analysed 421 participants with available LAVi and 276 proteomic measurements (Olink) at baseline, month 1 and 9 (mean age 73 ± 6 years; women 26%; LAVi 32 ± 9 ml/m2). Circulating proteins associated with LAVi were also assessed in asymptomatic individuals from a population‐based cohort (STANISLAS; n = 1640; mean age 49 ± 14 years; women 51%; LAVi 23 ± 7 ml/m2). In both studies, greater LAVi was significantly associated with greater left ventricular masses and volumes. In HOMAGE, after adjustment and correction for multiple testing, greater LAVi was associated with higher concentrations of matrix metallopeptidase‐2 (MMP‐2), insulin‐like growth factor binding protein‐2 (IGFBP‐2) and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) (false discovery rates [FDR] <0.05). These associations were externally replicated in STANISLAS (all FDR <0.05). Among these biomarkers, spironolactone decreased concentrations of MMP‐2 and NT‐proBNP, regardless of baseline LAVi (pinteraction > 0.10). Spironolactone also significantly reduced LAVi, improved left ventricular ejection fraction, lowered E/e', blood pressure and serum procollagen type I C‐terminal propeptide (PICP) concentration, a collagen synthesis marker, regardless of baseline LAVi (pinteraction > 0.10). Conclusion: In individuals without heart failure, LAVi was associated with MMP‐2, IGFBP‐2 and NT‐proBNP. Spironolactone reduced these biomarker concentrations as well as LAVi and PICP, irrespective of left atrial size. [ABSTRACT FROM AUTHOR]

Published
2024
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39. Intravenous iron for heart failure, iron deficiency definitions, and clinical response: the IRONMAN trial.

Author

Cleland, John G F, Kalra, Philip A, Pellicori, Pierpaolo, Graham, Fraser J, Foley, Paul W X, Squire, Iain B, Cowburn, Peter J, Seed, Alison, Clark, Andrew L, Szwejkowski, Ben, Banerjee, Prithwish, Cooke, Justin, Francis, Mark, Clifford, Piers, Wong, Aaron, Petrie, Colin, McMurray, John J V, Thomson, Elizabeth A, Wetherall, Kirsty, and Robertson, Michele

Subjects
IRON deficiency, HEART failure, HEART failure patients, FERRITIN, TRANSFERRIN
Abstract

Background and Aims What is the relationship between blood tests for iron deficiency, including anaemia, and the response to intravenous iron in patients with heart failure? Methods In the IRONMAN trial, 1137 patients with heart failure, ejection fraction ≤ 45%, and either serum ferritin < 100 µg/L or transferrin saturation (TSAT) < 20% were randomized to intravenous ferric derisomaltose (FDI) or usual care. Relationships were investigated between baseline anaemia severity, ferritin and TSAT, to changes in haemoglobin from baseline to 4 months, Minnesota Living with Heart Failure (MLwHF) score and 6-minute walk distance achieved at 4 months, and clinical events, including heart failure hospitalization (recurrent) or cardiovascular death. Results The rise in haemoglobin after administering FDI, adjusted for usual care, was greater for lower baseline TSAT (P interaction <.0001) and ferritin (P interaction =.028) and more severe anaemia (P interaction =.014). MLwHF scores at 4 months were somewhat lower (better) with FDI for more anaemic patients (overall P interaction =.14; physical P interaction =.085; emotional P interaction =.043) but were not related to baseline TSAT or ferritin. Blood tests did not predict difference in achieved walking distance for those randomized to FDI compared to control. The absence of anaemia or a TSAT ≥ 20% was associated with lower event rates and little evidence of benefit from FDI. More severe anaemia or TSAT < 20%, especially when ferritin was ≥100 µg/L, was associated with higher event rates and greater absolute reductions in events with FDI, albeit not statistically significant. Conclusions This hypothesis-generating analysis suggests that anaemia or TSAT < 20% with ferritin > 100 µg/L might identify patients with heart failure who obtain greater benefit from intravenous iron. This interpretation requires confirmation. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Phenotyping patients with ischaemic heart disease at risk of developing heart failure: an analysis of the HOMAGE trial

Author

Santos‐Ferreira, Diogo, primary, Diaz, Sílvia O., additional, Ferreira, João Pedro, additional, Girerd, Nicolas, additional, Pellicori, Pierpaolo, additional, Mariottoni, Beatrice, additional, Cosmi, Franco, additional, Hazebroek, Mark, additional, Verdonschot, Job A.J., additional, Cuthbert, Joe, additional, Petutschnigg, Johannes, additional, Heymans, Stephane, additional, Staessen, Jan A., additional, Pieske, Burkert, additional, Edelmann, Frank, additional, Clark, Andrew L., additional, Rossignol, Patrick, additional, Fontes‐Carvalho, Ricardo, additional, Cleland, John G.F., additional, and Zannad, Faiez, additional

Published
2023
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41. A novel, small-volume subcutaneous furosemide formulation delivered by an abdominal patch infusor device in patients with heart failure: results of two phase I studies

Author

Osmanska, Joanna, primary, Brooksbank, Katriona, additional, Docherty, Kieran F, additional, Robertson, Stacy, additional, Wetherall, Kirsty, additional, McConnachie, Alex, additional, Hu, Jerry, additional, Gardner, Roy S, additional, Clark, Andrew L, additional, Squire, Iain B, additional, Kalra, Paul R, additional, Jhund, Pardeep S, additional, Muntendam, Pieter, additional, McMurray, John J V, additional, Petrie, Mark C, additional, and Campbell, Ross T, additional

Published
2023
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42. Prognosis and Personalized In Silico Prediction of Treatment Efficacy in Cardiovascular and Chronic Kidney Disease: A Proof-of-Concept Study

Author

Jaimes Campos, Mayra Alejandra, primary, Andújar, Iván, additional, Keller, Felix, additional, Mayer, Gert, additional, Rossing, Peter, additional, Staessen, Jan A., additional, Delles, Christian, additional, Beige, Joachim, additional, Glorieux, Griet, additional, Clark, Andrew L., additional, Mullen, William, additional, Schanstra, Joost P., additional, Vlahou, Antonia, additional, Rossing, Kasper, additional, Peter, Karlheinz, additional, Ortiz, Alberto, additional, Campbell, Archie, additional, Persson, Frederik, additional, Latosinska, Agnieszka, additional, Mischak, Harald, additional, Siwy, Justyna, additional, and Jankowski, Joachim, additional

Published
2023
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