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4. The Effect of Omecamtiv Mecarbil in Hospitalized Patients as Compared With Outpatients With HFrEF: An Analysis of GALACTIC-HF

Author

DOCHERTY, KIERAN F., MCMURRAY, JOHN J.V., DIAZ, RAFAEL, FELKER, G. MICHAEL, METRA, MARCO, SOLOMON, SCOTT D., ADAMS, KIRKWOOD F., BÖHM, MICHAEL, BRINKLEY, DOUGLAS MARSHALL, ECHEVERRIA, LUIS E., GOUDEV, ASSEN R., HOWLETT, JONATHAN G., LUND, MAYANNA, PONIKOWSKI, PIOTR, YILMAZ, MEHMET B., ZANNAD, FAIEZ, CLAGGETT, BRIAN L., MIAO, ZI MICHAEL, ABBASI, SIDDIQUE A., DIVANJI, PUNAG, HEITNER, STEPHEN B., KUPFER, STUART, MALIK, FADY I., and TEERLINK, JOHN R.

Published
2024
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8. Baseline Predictors of Adverse Outcomes for Transthyretin Amyloidosis Cardiomyopathy Patients Treated and Untreated with Tafamidis: A Canadian Referral Center Experience.

Author

Shahi, Karan, Miller, Robert J. H., Dykstra, Steven, Feng, Yuanchao, Howlett, Jonathan G., Jimenez-Zepeda, Victor, Veenhuyzen, Jan, White, James A., and Fine, Nowell M.

Abstract

Background: Tafamidis is a costly therapy that improves outcomes for patients with transthyretin amyloidosis cardiomyopathy (ATTR-CM), although significant knowledge gaps exist for predicting longer-term response to treatment. The purpose of this study was to examine baseline predictors of adverse outcomes and their association with tafamidis treatment in comparison with those untreated in a clinical cohort from a Canadian ATTR-CM referral center. Methods: Patients with a confirmed diagnosis of ATTR-CM were included. Multivariable modeling was used to identify baseline variables associated with the primary outcome of all-cause mortality and secondary outcomes of cardiovascular mortality or hospitalization. Cox proportional hazard and competing risk analyses were used, with tafamidis modeled as a time-varying covariate. Results: In total, 139 ATTR-CM patients were included, with a median age of 80.9 years [74.3–86.6 years], from 2011 to 2022. The mean follow-up was 2.9 ± 1.8 years. Eighty (55%) patients were treated with tafamidis. All-cause mortality and cardiovascular mortality alone were associated with the following baseline variables: age, clinical frailty scale, systolic blood pressure, renal function, and right ventricular size and function (all p < 0.05), with no identified interactions with tafamidis treatment. Only baseline renal function was associated with cardiovascular hospitalization (p < 0.05). Conclusion: Important baseline variables associated with adverse ATTR-CM disease outcomes included renal function, systolic blood pressure, frailty, and right ventricular size and function. The risk factors were independent of treatment with tafamidis. These findings may help improve risk stratification for determining eligibility for ATTR-CM therapies. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Efficacy of Dapagliflozin in Black Versus White Patients With Heart Failure and Reduced Ejection Fraction

Author

Docherty, Kieran F., Ogunniyi, Modele O., Anand, Inder S., Desai, Akshay S., Diez, Mirta, Howlett, Jonathan G., Nicolau, Jose C., O’Meara, Eileen, Verma, Subodh, Inzucchi, Silvio E., Køber, Lars, Kosiborod, Mikhail N., Lindholm, Daniel, Martinez, Felipe A., Bengtsson, Olof, Ponikowski, Piotr, Sabatine, Marc S., Sjöstrand, Mikaela, Solomon, Scott D., Langkilde, Anna Maria, Jhund, Pardeep S., and McMurray, John J.V.

Published
2022
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10. CCS/CHFS Heart Failure Guidelines Update: Defining a New Pharmacologic Standard of Care for Heart Failure With Reduced Ejection Fraction

Author

McDonald, Michael, Virani, Sean, Chan, Michael, Ducharme, Anique, Ezekowitz, Justin A., Giannetti, Nadia, Heckman, George A., Howlett, Jonathan G., Koshman, Sheri L., Lepage, Serge, Mielniczuk, Lisa, Moe, Gordon W., O’Meara, Eileen, Swiggum, Elizabeth, Toma, Mustafa, Zieroth, Shelley, Anderson, Kim, Bray, Sharon A., Clarke, Brian, Cohen-Solal, Alain, D’Astous, Michel, Davis, Margot, De, Sabe, Grant, Andrew D.M., Grzeslo, Adam, Heshka, Jodi, Keen, Sabina, Kouz, Simon, Lee, Douglas, Masoudi, Frederick A., McKelvie, Robert, Parent, Marie-Claude, Poon, Stephanie, Rajda, Miroslaw, Sharma, Abhinav, Siatecki, Kyla, Storm, Kate, Sussex, Bruce, Van Spall, Harriette, and Yip, Amelia Ming Ching

Published
2021
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12. Hypertension Canada’s 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children

Author

Rabi, Doreen M., McBrien, Kerry A., Sapir-Pichhadze, Ruth, Nakhla, Meranda, Ahmed, Sofia B., Dumanski, Sandra M., Butalia, Sonia, Leung, Alexander A., Harris, Kevin C., Cloutier, Lyne, Zarnke, Kelly B., Ruzicka, Marcel, Hiremath, Swapnil, Feldman, Ross D., Tobe, Sheldon W., Campbell, Tavis S., Bacon, Simon L., Nerenberg, Kara A., Dresser, George K., Fournier, Anne, Burgess, Ellen, Lindsay, Patrice, Rabkin, Simon W., Prebtani, Ally P.H., Grover, Steven, Honos, George, Alfonsi, Jeffrey E., Arcand, JoAnne, Audibert, François, Benoit, Geneviève, Bittman, Jesse, Bolli, Peter, Côté, Anne-Marie, Dionne, Janis, Don-Wauchope, Andrew, Edwards, Cedric, Firoz, Tabassum, Gabor, Jonathan Y., Gilbert, Richard E., Grégoire, Jean C., Gryn, Steven E., Gupta, Milan, Hannah-Shmouni, Fady, Hegele, Robert A., Herman, Robert J., Hill, Michael D., Howlett, Jonathan G., Hundemer, Gregory L., Jones, Charlotte, Kaczorowski, Janusz, Khan, Nadia A., Kuyper, Laura M., Lamarre-Cliche, Maxime, Lavoie, Kim L., Leiter, Lawrence A., Lewanczuk, Richard, Logan, Alexander G., Magee, Laura A., Mangat, Birinder K., McFarlane, Philip A., McLean, Donna, Michaud, Andre, Milot, Alain, Moe, Gordon W., Penner, S. Brian, Pipe, Andrew, Poppe, Alexandre Y., Rey, Evelyne, Roerecke, Michael, Schiffrin, Ernesto L., Selby, Peter, Sharma, Mike, Shoamanesh, Ashkan, Sivapalan, Praveena, Townsend, Raymond R., Tran, Karen, Trudeau, Luc, Tsuyuki, Ross T., Vallée, Michel, Woo, Vincent, Bell, Alan D., and Daskalopoulou, Stella S.

Published
2020
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14. Canadian Cardiovascular Society/Canadian Heart Failure Society Joint Position Statement on the Evaluation and Management of Patients With Cardiac Amyloidosis

Author

Fine, Nowell M., Davis, Margot K., Anderson, Kim, Delgado, Diego H., Giraldeau, Genevieve, Kitchlu, Abhijat, Massie, Rami, Narayan, Jane, Swiggum, Elizabeth, Venner, Christopher P., Ducharme, Anique, Galant, Natalie J., Hahn, Christopher, Howlett, Jonathan G., Mielniczuk, Lisa, Parent, Marie-Claude, Reece, Donna, Royal, Virginie, Toma, Mustafa, Virani, Sean A., and Zieroth, Shelley

Published
2020
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15. CCS/CHFS Heart Failure Guidelines: Clinical Trial Update on Functional Mitral Regurgitation, SGLT2 Inhibitors, ARNI in HFpEF, and Tafamidis in Amyloidosis

Author

O’Meara, Eileen, McDonald, Michael, Chan, Michael, Ducharme, Anique, Ezekowitz, Justin A., Giannetti, Nadia, Grzeslo, Adam, Heckman, George A., Howlett, Jonathan G., Koshman, Sheri L., Lepage, Serge, Mielniczuk, Lisa M., Moe, Gordon W., Swiggum, Elizabeth, Toma, Mustafa, Virani, Sean A., Zieroth, Shelley, De, Sabe, Matteau, Sylvain, Parent, Marie-Claude, Asgar, Anita W., Cohen, Gideon, Fine, Nowell, Davis, Margot, Verma, Subodh, Cherney, David, Abrams, Howard, Al-Hesayen, Abdul, Cohen-Solal, Alain, D’Astous, Michel, Delgado, Diego H., Desplantie, Olivier, Estrella-Holder, Estrellita, Green, Lee, Haddad, Haissam, Harkness, Karen, Hernandez, Adrian F., Kouz, Simon, LeBlanc, Marie-Hélène, Lee, Douglas, Masoudi, Frederick A., McKelvie, Robert S., Rajda, Miroslaw, Ross, Heather J., and Sussex, Bruce

Published
2020
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17. Feasibility of Sildenafil for the Prevention of Right Heart Failure Following Continuous-Flow Left Ventricular Assist Device Implantation: The REVAD Trial

Author

Fine, Nowell M., primary, Litwin, Owen, additional, Kent, William D.T., additional, Holloway, Daniel D., additional, Roy, Jill, additional, Miller, Robert J.H., additional, Chih, Sharon, additional, Davey, Ryan A., additional, Isaac, Debra L., additional, Sharma, Nakul, additional, Lyons, Kristin J., additional, and Howlett, Jonathan G., additional

Published
2023
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19. CABG Improves Outcomes in Patients With Ischemic Cardiomyopathy: 10-Year Follow-Up of the STICH Trial

Author

Howlett, Jonathan G., Stebbins, Amanda, Petrie, Mark C., Jhund, Pardeep S., Castelvecchio, Serenella, Cherniavsky, Alexander, Sueta, Carla A., Roy, Ambuj, Piña, Ileana L., Wurm, Raphael, Drazner, Mark H., Andersson, Bert, Batlle, Carmen, Senni, Michele, Chrzanowski, Lukasz, Merkely, Bela, Carson, Peter, Desvigne-Nickens, Patrice M., Lee, Kerry L., Velazquez, Eric J., and Al-Khalidi, Hussein R.

Published
2019
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23. Hypertension Canada’s 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children

Author

Nerenberg, Kara A., Zarnke, Kelly B., Leung, Alexander A., Dasgupta, Kaberi, Butalia, Sonia, McBrien, Kerry, Harris, Kevin C., Nakhla, Meranda, Cloutier, Lyne, Gelfer, Mark, Lamarre-Cliche, Maxime, Milot, Alain, Bolli, Peter, Tremblay, Guy, McLean, Donna, Padwal, Raj S., Tran, Karen C., Grover, Steven, Rabkin, Simon W., Moe, Gordon W., Howlett, Jonathan G., Lindsay, Patrice, Hill, Michael D., Sharma, Mike, Field, Thalia, Wein, Theodore H., Shoamanesh, Ashkan, Dresser, George K., Hamet, Pavel, Herman, Robert J., Burgess, Ellen, Gryn, Steven E., Grégoire, Jean C., Lewanczuk, Richard, Poirier, Luc, Campbell, Tavis S., Feldman, Ross D., Lavoie, Kim L., Tsuyuki, Ross T., Honos, George, Prebtani, Ally P.H., Kline, Gregory, Schiffrin, Ernesto L., Don-Wauchope, Andrew, Tobe, Sheldon W., Gilbert, Richard E., Leiter, Lawrence A., Jones, Charlotte, Woo, Vincent, Hegele, Robert A., Selby, Peter, Pipe, Andrew, McFarlane, Philip A., Oh, Paul, Gupta, Milan, Bacon, Simon L., Kaczorowski, Janusz, Trudeau, Luc, Campbell, Norman R.C., Hiremath, Swapnil, Roerecke, Michael, Arcand, Joanne, Ruzicka, Marcel, Prasad, G.V. Ramesh, Vallée, Michel, Edwards, Cedric, Sivapalan, Praveena, Penner, S. Brian, Fournier, Anne, Benoit, Geneviève, Feber, Janusz, Dionne, Janis, Magee, Laura A., Logan, Alexander G., Côté, Anne-Marie, Rey, Evelyne, Firoz, Tabassum, Kuyper, Laura M., Gabor, Jonathan Y., Townsend, Raymond R., Rabi, Doreen M., and Daskalopoulou, Stella S.

Published
2018
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24. 2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure

Author

Ezekowitz, Justin A., O'Meara, Eileen, McDonald, Michael A., Abrams, Howard, Chan, Michael, Ducharme, Anique, Giannetti, Nadia, Grzeslo, Adam, Hamilton, Peter G., Heckman, George A., Howlett, Jonathan G., Koshman, Sheri L., Lepage, Serge, McKelvie, Robert S., Moe, Gordon W., Rajda, Miroslaw, Swiggum, Elizabeth, Virani, Sean A., Zieroth, Shelley, Al-Hesayen, Abdul, Cohen-Solal, Alain, D'Astous, Michel, De, Sabe, Estrella-Holder, Estrellita, Fremes, Stephen, Green, Lee, Haddad, Haissam, Harkness, Karen, Hernandez, Adrian F., Kouz, Simon, LeBlanc, Marie-Hélène, Masoudi, Frederick A., Ross, Heather J., Roussin, Andre, and Sussex, Bruce

Published
2017
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27. Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults

Author

Leung, Alexander A., Daskalopoulou, Stella S., Dasgupta, Kaberi, McBrien, Kerry, Butalia, Sonia, Zarnke, Kelly B., Nerenberg, Kara, Harris, Kevin C., Nakhla, Meranda, Cloutier, Lyne, Gelfer, Mark, Lamarre-Cliche, Maxime, Milot, Alain, Bolli, Peter, Tremblay, Guy, McLean, Donna, Tobe, Sheldon W., Ruzicka, Marcel, Burns, Kevin D., Vallée, Michel, Prasad, G.V. Ramesh, Gryn, Steven E., Feldman, Ross D., Selby, Peter, Pipe, Andrew, Schiffrin, Ernesto L., McFarlane, Philip A., Oh, Paul, Hegele, Robert A., Khara, Milan, Wilson, Thomas W., Penner, S. Brian, Burgess, Ellen, Sivapalan, Praveena, Herman, Robert J., Bacon, Simon L., Rabkin, Simon W., Gilbert, Richard E., Campbell, Tavis S., Grover, Steven, Honos, George, Lindsay, Patrice, Hill, Michael D., Coutts, Shelagh B., Gubitz, Gord, Campbell, Norman R.C., Moe, Gordon W., Howlett, Jonathan G., Boulanger, Jean-Martin, Prebtani, Ally, Kline, Gregory, Leiter, Lawrence A., Jones, Charlotte, Côté, Anne-Marie, Woo, Vincent, Kaczorowski, Janusz, Trudeau, Luc, Tsuyuki, Ross T., Hiremath, Swapnil, Drouin, Denis, Lavoie, Kim L., Hamet, Pavel, Grégoire, Jean C., Lewanczuk, Richard, Dresser, George K., Sharma, Mukul, Reid, Debra, Lear, Scott A., Moullec, Gregory, Gupta, Milan, Magee, Laura A., Logan, Alexander G., Dionne, Janis, Fournier, Anne, Benoit, Geneviève, Feber, Janusz, Poirier, Luc, Padwal, Raj S., and Rabi, Doreen M.

Published
2017
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28. Dapagliflozin and Diuretic Use in Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF

Author

Jackson, Alice M., Dewan, Pooja, Anand, Inder S., Bělohlávek, Jan, Bengtsson, Olof, de Boer, Rudolf A., Böhm, Michael, Boulton, David W., Chopra, Vijay K., DeMets, David L., Docherty, Kieran F., Dukát, Andrej, Greasley, Peter J., Howlett, Jonathan G., Inzucchi, Silvio E., Katova, Tzvetana, Køber, Lars, Kosiborod, Mikhail N., Langkilde, Anna Maria, Lindholm, Daniel, Ljungman, Charlotta E.A., Martinez, Felipe A., O’Meara, Eileen, Sabatine, Marc S., Sjöstrand, Mikaela, Solomon, Scott D., Tereshchenko, Sergey, Verma, Subodh, Jhund, Pardeep S., and McMurray, John J.V.

Published
2020
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32. Geographic Differences in Patients in a Global Acute Heart Failure Clinical Trial (from the ASCEND-HF Trial)

Author

Metra, Marco, Mentz, Robert J., Hernandez, Adrian F., Heizer, Gretchen M., Armstrong, Paul W., Clausell, Nadine, Corbalan, Ramon, Costanzo, Maria Rosa, Dickstein, Kenneth, Dunlap, Mark E., Ezekowitz, Justin A., Howlett, Jonathan G., Komajda, Michel, Krum, Henry, Lombardi, Carlo, Fonarow, Gregg C., McMurray, John J.V., Nieminen, Markku S., Swedberg, Karl, Voors, Adriaan A., Starling, Randall C., Teerlink, John R., and O'Connor, Christopher M.

Published
2016
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33. Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension

Author

Leung, Alexander A., Nerenberg, Kara, Daskalopoulou, Stella S., McBrien, Kerry, Zarnke, Kelly B., Dasgupta, Kaberi, Cloutier, Lyne, Gelfer, Mark, Lamarre-Cliche, Maxime, Milot, Alain, Bolli, Peter, Tremblay, Guy, McLean, Donna, Tobe, Sheldon W., Ruzicka, Marcel, Burns, Kevin D., Vallée, Michel, Prasad, G.V. Ramesh, Lebel, Marcel, Feldman, Ross D., Selby, Peter, Pipe, Andrew, Schiffrin, Ernesto L., McFarlane, Philip A., Oh, Paul, Hegele, Robert A., Khara, Milan, Wilson, Thomas W., Penner, S. Brian, Burgess, Ellen, Herman, Robert J., Bacon, Simon L., Rabkin, Simon W., Gilbert, Richard E., Campbell, Tavis S., Grover, Steven, Honos, George, Lindsay, Patrice, Hill, Michael D., Coutts, Shelagh B., Gubitz, Gord, Campbell, Norman R.C., Moe, Gordon W., Howlett, Jonathan G., Boulanger, Jean-Martin, Prebtani, Ally, Larochelle, Pierre, Leiter, Lawrence A., Jones, Charlotte, Ogilvie, Richard I., Woo, Vincent, Kaczorowski, Janusz, Trudeau, Luc, Petrella, Robert J., Hiremath, Swapnil, Drouin, Denis, Lavoie, Kim L., Hamet, Pavel, Fodor, George, Grégoire, Jean C., Lewanczuk, Richard, Dresser, George K., Sharma, Mukul, Reid, Debra, Lear, Scott A., Moullec, Gregory, Gupta, Milan, Magee, Laura A., Logan, Alexander G., Harris, Kevin C., Dionne, Janis, Fournier, Anne, Benoit, Geneviève, Feber, Janusz, Poirier, Luc, Padwal, Raj S., and Rabi, Doreen M.

Published
2016
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34. The Canadian Cardiovascular Society Heart Failure Companion: Bridging Guidelines to Your Practice

Author

Howlett, Jonathan G., Chan, Michael, Ezekowitz, Justin A., Harkness, Karen, Heckman, George A., Kouz, Simon, Leblanc, Marie-Hélène, Moe, Gordon W., O’Meara, Eileen, Abrams, Howard, Ducharme, Anique, Grzeslo, Adam, Hamilton, Peter G., Koshman, Sheri L., Lepage, Serge, McDonald, Michael, McKelvie, Robert, Rajda, Miroslaw, Swiggum, Elizabeth, Virani, Sean, and Zieroth, Shelley

Published
2016
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38. The 2015 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension

Author

Daskalopoulou, Stella S., Rabi, Doreen M., Zarnke, Kelly B., Dasgupta, Kaberi, Nerenberg, Kara, Cloutier, Lyne, Gelfer, Mark, Lamarre-Cliche, Maxime, Milot, Alain, Bolli, Peter, McKay, Donald W., Tremblay, Guy, McLean, Donna, Tobe, Sheldon W., Ruzicka, Marcel, Burns, Kevin D., Vallée, Michel, Ramesh Prasad, G.V., Lebel, Marcel, Feldman, Ross D., Selby, Peter, Pipe, Andrew, Schiffrin, Ernesto L., McFarlane, Philip A., Oh, Paul, Hegele, Robert A., Khara, Milan, Wilson, Thomas W., Brian Penner, S., Burgess, Ellen, Herman, Robert J., Bacon, Simon L., Rabkin, Simon W., Gilbert, Richard E., Campbell, Tavis S., Grover, Steven, Honos, George, Lindsay, Patrice, Hill, Michael D., Coutts, Shelagh B., Gubitz, Gord, Campbell, Norman R.C., Moe, Gordon W., Howlett, Jonathan G., Boulanger, Jean-Martin, Prebtani, Ally, Larochelle, Pierre, Leiter, Lawrence A., Jones, Charlotte, Ogilvie, Richard I., Woo, Vincent, Kaczorowski, Janusz, Trudeau, Luc, Petrella, Robert J., Hiremath, Swapnil, Stone, James A., Drouin, Denis, Lavoie, Kim L., Hamet, Pavel, Fodor, George, Grégoire, Jean C., Fournier, Anne, Lewanczuk, Richard, Dresser, George K., Sharma, Mukul, Reid, Debra, Benoit, Geneviève, Feber, Janusz, Harris, Kevin C., Poirier, Luc, and Padwal, Raj S.

Published
2015
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39. The 2014 Canadian Cardiovascular Society Heart Failure Management Guidelines Focus Update: Anemia, Biomarkers, and Recent Therapeutic Trial Implications

Author

Moe, Gordon W., Ezekowitz, Justin A., O'Meara, Eileen, Lepage, Serge, Howlett, Jonathan G., Fremes, Steve, Al-Hesayen, Abdul, Heckman, George A., Abrams, Howard, Ducharme, Anique, Estrella-Holder, Estrellita, Grzeslo, Adam, Harkness, Karen, Koshman, Sheri L., McDonald, Michael, McKelvie, Robert, Rajda, Miroslaw, Rao, Vivek, Swiggum, Elizabeth, Virani, Sean, Zieroth, Shelley, Arnold, J.Malcolm O., Ashton, Tom, D'Astous, Michel, Chan, Michael, De, Sabe, Dorian, Paul, Giannetti, Nadia, Haddad, Haissam, Isaac, Debra L., Kouz, Simon, Leblanc, Marie-Hélène, Liu, Peter, Ross, Heather J., Sussex, Bruce, and White, Michel

Published
2015
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40. Hematopoietic Cell Transplantation for Systemic Sclerosis—A Review

Author

Levin, Daniel, primary, Osman, Mohammed S., additional, Durand, Caylib, additional, Kim, Hyein, additional, Hemmati, Iman, additional, Jamani, Kareem, additional, Howlett, Jonathan G., additional, Johannson, Kerri A., additional, Weatherald, Jason, additional, Woo, Matthew, additional, Lee, Jason, additional, and Storek, Jan, additional

Published
2022
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46. Effects of omecamtiv mecarbil in heart failure with reduced ejection fraction according to blood pressure: the GALACTIC-HF trial

Author

Metra, Marco, Pagnesi, Matteo, Claggett, Brian L., Díaz, Rafael, Felker, G. Michael, McMurray, John J. V., Solomon, Scott D., Bonderman, Diana, Fang, James C., Fonseca, Cândida, Goncalvesova, Eva, Howlett, Jonathan G., Li, Jing, O'Meara, Eileen, Miao, Zi Michael, Abbasi, Siddique A., Heitner, Stephen B., Kupfer, Stuart, Malik, Fady I., Teerlink, John R., and on behalf of the GALACTIC-HF Investigators

Abstract

Aim:\ud Patients with heart failure with reduced ejection fraction and low systolic blood pressure (SBP) have high mortality, hospitalizations, and poorly tolerate evidence-based medical treatment. Omecamtiv mecarbil may be particularly helpful in such patients. This study examined its efficacy and tolerability in patients with SBP ≤100 mmHg enrolled in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC-HF).\ud \ud Methods and results:\ud The GALACTIC-HF enrolled patients with baseline SBP ≥85 mmHg with a primary outcome of time to cardiovascular death or first heart failure event. In this analysis, patients were divided according to their baseline SBP (≤100 vs. >100 mmHg). Among the 8232 analysed patients, 1473 (17.9%) had baseline SBP ≤100 mmHg and 6759 (82.1%) had SBP >100 mmHg. The primary outcome occurred in 715 (48.5%) and 2415 (35.7%) patients with SBP ≤100 and >100 mmHg, respectively. Patients with lower SBP were at higher risk of adverse outcomes. Omecamtiv mecarbil, compared with placebo, appeared to be more effective in reducing the primary composite endpoint in patients with SBP ≤100 mmHg [hazard ratio (HR), 0.81; 95% confidence interval (CI), 0.70–0.94] compared with those with SBP >100 mmHg (HR, 0.95; 95% CI, 0.88–1.03; P-value for interaction = 0.051). In both groups, omecamtiv mecarbil did not change SBP values over time and did not increase the risk of adverse events, when compared with placebo.\ud \ud Conclusion:\ud In GALACTIC-HF, risk reduction of heart failure outcomes with omecamtiv mecarbil compared with placebo was large and significant in patients with low SBP. Omecamtiv mecarbil did not affect SBP and was well tolerated independent of SBP values.

Published
2022

49. Dapagliflozin and atrial fibrillation in heart failure with reduced ejection fraction:insights from DAPA-HF

Author

Butt, Jawad H., Docherty, Kieran F., Jhund, Pardeep S., de Boer, Rudolf A., Böhm, Michael, Desai, Akshay S., Howlett, Jonathan G., Inzucchi, Silvio E., Kosiborod, Mikhail N., Martinez, Felipe A., Nicolau, Jose C., Petrie, Mark C., Ponikowski, Piotr, Bengtsson, Olof, Langkilde, Anna Maria, Schou, Morten, Sjöstrand, Mikaela, Solomon, Scott D., Sabatine, Marc S., McMurray, John J.V., Køber, Lars, Butt, Jawad H., Docherty, Kieran F., Jhund, Pardeep S., de Boer, Rudolf A., Böhm, Michael, Desai, Akshay S., Howlett, Jonathan G., Inzucchi, Silvio E., Kosiborod, Mikhail N., Martinez, Felipe A., Nicolau, Jose C., Petrie, Mark C., Ponikowski, Piotr, Bengtsson, Olof, Langkilde, Anna Maria, Schou, Morten, Sjöstrand, Mikaela, Solomon, Scott D., Sabatine, Marc S., McMurray, John J.V., and Køber, Lars

Abstract

Aims: Among patients with heart failure (HF) and reduced ejection fraction (HFrEF), those with atrial fibrillation (AF) may respond differently to certain treatments than patients without AF. We investigated the efficacy and safety of dapagliflozin in patients with HFrEF with and without AF in the Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure trial (DAPA-HF). We also examined the effect of dapagliflozin on new-onset AF. Methods and results: The primary outcome was the composite of an episode of worsening HF (HF hospitalization or urgent HF visit requiring intravenous therapy) or cardiovascular death. Of the 4744 patients randomized, 1910 (40.3%) had ‘any AF’ (history of AF or AF on enrolment electrocardiogram). Compared with placebo, dapagliflozin reduced the risk of worsening HF or cardiovascular death to a similar extent in patients with and without any AF [hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.62–0.92 and 0.74, 95% CI 0.62–0.88, respectively; p for interaction = 0.88]. Consistent benefits were observed for the components of the primary outcome, all-cause mortality, and improvement of Kansas City Cardiomyopathy Questionnaire total symptom score. Among patients without AF at baseline, dapagliflozin did not significantly reduce the risk of new-onset AF compared with placebo (HR 0.86, 95% CI 0.60–1.22). However, patients with new-onset AF had a 5 to 6-fold higher risk of adverse outcomes when compared to those without incident AF. Conclusions: Dapagliflozin, compared with placebo, reduced the risk of worsening HF events, cardiovascular death, and all-cause death, and improved symptoms, in patients with and without AF. Dapagliflozin did not reduce the risk of new-onset AF.

Published
2022

50. Assessment of Omecamtiv Mecarbil for the Treatment of Patients With Severe Heart Failure A Post Hoc Analysis of Data From the GALACTIC-HF Randomized Clinical Trial

Author

Felker, G. Michael, Solomon, Scott D., Claggett, Brian, Diaz, Rafael, McMurray, John J. V, Metra, Marco, Anand, Inder, Crespo-Leiro, Marisa G., Dahlström, Ulf, Goncalvesova, Eva, Howlett, Jonathan G., MacDonald, Peter, Parkhomenko, Alexander, Tomcsanyi, Janos, Abbasi, Siddique A., Heitner, Stephen B., Hucko, Thomas, Kupfer, Stuart, Malik, Fady I, Teerlink, John R., Felker, G. Michael, Solomon, Scott D., Claggett, Brian, Diaz, Rafael, McMurray, John J. V, Metra, Marco, Anand, Inder, Crespo-Leiro, Marisa G., Dahlström, Ulf, Goncalvesova, Eva, Howlett, Jonathan G., MacDonald, Peter, Parkhomenko, Alexander, Tomcsanyi, Janos, Abbasi, Siddique A., Heitner, Stephen B., Hucko, Thomas, Kupfer, Stuart, Malik, Fady I, and Teerlink, John R.

Abstract

IMPORTANCE Heart failure with reduced ejection fraction is a progressive clinical syndrome, and many patients condition worsen over time despite treatment. Patients with more severe disease are often intolerant of available medical therapies. OBJECTIVE To evaluate the efficacy and safety of omecamtiv mecarbil for the treatment of patients with severe heart failure (HF) enrolled in the Global Approach to Lowering Adverse Cardiac Outcomes Through Improving Contractility in Heart Failure (GALACTIC-HF) randomized clinical trial. DESIGN, SETTING, AND PARTICIPANTS The GALACTIC-HF study was a global double-blind, placebo-controlled phase 3 randomized clinical trial that was conducted at multiple centers between January 2017 and August 2020. A total of 8232 patients with symptomatic HF (defined as New York Heart Association symptom class II-IV) and left ventricular ejection fraction of 35% or less were randomized to receive omecamtiv mecarbil or placebo and followed up for a median of 21.8 months (range, 15.4-28.6 months). The current post hoc analysis evaluated the efficacy and safety of omecamtiv mecarbil therapy among patients classified as having severe HF compared with patients without severe HF. Severe HF was defined as the presence of all of the following criteria: New York Heart Association symptom class III to IV, left ventricular ejection fraction of 30% or less, and hospitalization for HF within the previous 6 months. INTERVENTIONS Participants were randomized at a 1:1 ratio to receive either omecamtiv mecarbil or placebo. MAIN OUTCOMES AND MEASURES The primary end point was time to first HF event or cardiovascular (CV) death. Secondary end points included time to CV death and safety and tolerability. RESULTS Among 8232 patients enrolled in the GALACTIC-HF clinical trial, 2258 patients (27.4%; mean [SD] age, 64.5 [11.6] years; 1781 men [78.9%]) met the specified criteria for severe HF. Of those, 1106 patients were randomized to the omecamtiv mecarbil group and 11, Funding Agencies|AmgenAmgen; Cytokinetics; Servier Laboratories

Published
2022
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