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408 results on '"Pocock, S. J."'

2. Impact of different antiplatelet therapy cessation modes on outcomes in patients treated with ticagrelor with or without aspirin after PCI: the twilight-antiplatelet cessation study

Author

Spirito, A, primary, Kastrati, A, additional, Moliterno, D J, additional, Baber, U, additional, Cao, D, additional, Sartori, S, additional, Collier, T, additional, Gibson, C M, additional, Angiolillo, D J, additional, Pocock, S J, additional, Cohen, D J, additional, Escaned, J, additional, Sardella, G, additional, Dangas, G, additional, and Mehran, R, additional

Published
2022
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3. Socioeconomic deprivation: an important largely unrecognized risk factor in primary prevention of cardiovascular disease

Author

Kimenai, D, primary, Pirondini, L, additional, Gregson, J, additional, Prieto, D, additional, Pocock, S J, additional, Perel, P, additional, Hamilton, T, additional, Welsh, P, additional, Campbell, A, additional, Porteous, D J, additional, Hayward, C, additional, Sattar, N, additional, Mills, N L, additional, and Shah, A S V, additional

Published
2022
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4. Association of heart rate with heart failure outcomes and the effects of empagliflozin in patients with preserved ejection fraction – EMPEROR-Preserved trial

Author

Boehm, M, primary, Anker, S D, additional, Mahfoud, F, additional, Filippatos, G, additional, Ferreira, J P, additional, Pocock, S J, additional, Brueckmann, M, additional, Linetzky, B, additional, Schueler, E, additional, Wanner, C, additional, Zannad, F, additional, Packer, M, additional, and Butler, J, additional

Published
2022
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6. Empagliflozin, Health Status, and Quality of Life in Patients With Heart Failure and Preserved Ejection Fraction: The EMPEROR-Preserved Trial

Author

Butler, J, Filippatos, G, Jamal Siddiqi, T, Brueckmann, M, Bohm, M, Chopra, V, Pedro Ferreira, J, Januzzi, J, Kaul, S, Pina, I, Ponikowski, P, Shah, S, Senni, M, Vedin, O, Verma, S, Peil, B, Pocock, S, Zannad, F, Packer, M, Anker, S, Butler J., Filippatos G., Jamal Siddiqi T., Brueckmann M., Bohm M., Chopra V. K., Pedro Ferreira J., Januzzi J. L., Kaul S., Pina I. L., Ponikowski P., Shah S. J., Senni M., Vedin O., Verma S., Peil B., Pocock S. J., Zannad F., Packer M., Anker S. D., Butler, J, Filippatos, G, Jamal Siddiqi, T, Brueckmann, M, Bohm, M, Chopra, V, Pedro Ferreira, J, Januzzi, J, Kaul, S, Pina, I, Ponikowski, P, Shah, S, Senni, M, Vedin, O, Verma, S, Peil, B, Pocock, S, Zannad, F, Packer, M, Anker, S, Butler J., Filippatos G., Jamal Siddiqi T., Brueckmann M., Bohm M., Chopra V. K., Pedro Ferreira J., Januzzi J. L., Kaul S., Pina I. L., Ponikowski P., Shah S. J., Senni M., Vedin O., Verma S., Peil B., Pocock S. J., Zannad F., Packer M., and Anker S. D.

Abstract

Background: Patients with heart failure with preserved ejection fraction have significant impairment in health-related quality of life. In the EMPEROR-Preserved trial (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Preserved Ejection Fraction), we evaluated the efficacy of empagliflozin on health-related quality of life in patients with heart failure with preserved ejection fraction and whether the clinical benefit observed with empagliflozin varies according to baseline health status. Methods: Health-related quality of life was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) at baseline and 12, 32, and 52 weeks. Patients were divided by baseline KCCQ Clinical Summary Score (CSS) tertiles, and the effect of empagliflozin on outcomes was examined. The effect of empagliflozin on KCCQ-CSS, Total Symptom Score, and Overall Summary Score was evaluated. Responder analyses were performed to compare the odds of improvement and deterioration in KCCQ related to treatment with empagliflozin. Results: The effect of empagliflozin on reducing the risk of time to cardiovascular death or heart failure hospitalization was consistent across baseline KCCQ-CSS tertiles (hazard ratio, 0.83 [95% CI, 0.69-1.00], 0.70 [95% CI, 0.55-0.88], and 0.82 [95% CI, 0.62-1.08] for scores <62.5, 62.5-83.3, and ≥83.3, respectively; P trend=0.77). Similar results were seen for total heart failure hospitalizations. Patients treated with empagliflozin had significant improvement in KCCQ-CSS versus placebo (+1.03, +1.24, and +1.50 at 12, 32, and 52 weeks, respectively; P<0.01); similar results were seen for Total Symptom Score and Overall Summary Score. At 12 weeks, patients on empagliflozin had higher odds of improvement ≥5 points (odds ratio, 1.23 [95% CI, 1.10-1.37]), ≥10 points (odds ratio, 1.15 [95% CI, 1.03-1.27]), and ≥15 points (odds ratio, 1.13 [95% CI, 1.02-1.26]) and lower odds of deterioration ≥5 points in KCCQ-CSS (odds ratio, 0.85 [95% CI, 0.7

Published
2022

7. Evaluation of the effect of sodium–glucose co‐transporter 2 inhibition with empagliflozin on morbidity and mortality of patients with chronic heart failure and a reduced ejection fraction: rationale for and design of the EMPEROR‐Reduced trial

Author

Packer M., Butler J., Filippatos G. S., Jamal W., Salsali A., Schnee J., Kimura K., Zeller C., George J., Brueckmann M., Anker S. D., Zannad F., Perrone S., Nicholls S., Janssens S., Bocchi E., Giannetti N., Verma S., Jian Z., Spinar J., Seronde M. -F., Bohm M., Merkely B., Chopra V., Senni M., Taddei S., Tsutsui H., Choi D. -J., Chuquiure E., La Rocca H. P. B., Ponikowski P., Juanatey J. R. G., Squire I., Januzzi J., Pina I., Pocock S. J., Carson P., Doehner W., Miller A., Haas M., Pehrson S., Komajda M., Anand I., Teerlink J., Rabinstein A., Steiner T., Kamel H., Tsivgoulis G., Lewis J., Freston J., Kaplowitz N., Mann J., Petrie M., Bernstein R., Cheung A., Green J., Kaul S., Ping C. L. S., Lip G., Marx N., McCullough P., Mehta C., Rosenstock J., Sattar N., Scirica B., Wanner C., Welty F. K., Parhofer K. G., Clayton T., Pedersen T. R., Lees K. R., Konstam M. A., Greenberg B., Palmer M., Packer, M, Butler, J, Filippatos, G, Jamal, W, Salsali, A, Schnee, J, Kimura, K, Zeller, C, George, J, Brueckmann, M, Anker, S, Zannad, F, Perrone, S, Nicholls, S, Janssens, S, Bocchi, E, Giannetti, N, Verma, S, Jian, Z, Spinar, J, Seronde, M, Bohm, M, Merkely, B, Chopra, V, Senni, M, Taddei, S, Tsutsui, H, Choi, D, Chuquiure, E, La Rocca, H, Ponikowski, P, Juanatey, J, Squire, I, Januzzi, J, Pina, I, Pocock, S, Carson, P, Doehner, W, Miller, A, Haas, M, Pehrson, S, Komajda, M, Anand, I, Teerlink, J, Rabinstein, A, Steiner, T, Kamel, H, Tsivgoulis, G, Lewis, J, Freston, J, Kaplowitz, N, Mann, J, Petrie, M, Bernstein, R, Cheung, A, Green, J, Kaul, S, Ping, C, Lip, G, Marx, N, Mccullough, P, Mehta, C, Rosenstock, J, Sattar, N, Scirica, B, Wanner, C, Welty, F, Parhofer, K, Clayton, T, Pedersen, T, Lees, K, Konstam, M, Greenberg, B, Palmer, M, RS: Carim - H02 Cardiomyopathy, MUMC+: MA Med Staf Spec Cardiologie (9), Cardiologie, and RS: CARIM - R2.02 - Cardiomyopathy

Subjects
MECHANISM, Trial design, medicine.medical_specialty, Cardiac & Cardiovascular Systems, NA+/H+-EXCHANGER, Heart failure, Type 2 diabetes, 030204 cardiovascular system & hematology, Diabete, SGLT2 INHIBITORS, Reduced ejection fraction, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Glucosides, Internal medicine, Diabetes mellitus, Clinical endpoint, Empagliflozin, Humans, Medicine, Benzhydryl Compounds, Dapagliflozin, Sodium-Glucose Transporter 2 Inhibitors, Randomized Controlled Trials as Topic, RISK, Canagliflozin, OUTCOMES, Science & Technology, Ejection fraction, diabetes, business.industry, Diabetes, Stroke Volume, SGLT2 inhibitor, medicine.disease, chemistry, HOSPITALIZATION, Chronic Disease, Cardiovascular System & Cardiology, Cardiology, Cardiology and Cardiovascular Medicine, business, Life Sciences & Biomedicine, medicine.drug
Abstract

Drugs that inhibit the sodium-glucose co-transporter 2 (SGLT2) have been shown to reduce the risk of hospitalizations for heart failure in patients with type 2 diabetes. In populations that largely did not have heart failure at the time of enrolment, empagliflozin, canagliflozin and dapagliflozin decreased the risk of serious new-onset heart failure events by ≈30%. In addition, in the EMPA-REG OUTCOME trial, empagliflozin reduced the risk of both pump failure and sudden deaths, the two most common modes of death among patients with heart failure. In none of the three trials could the benefits of SGLT2 inhibitors on heart failure be explained by the actions of these drugs as diuretics or anti-hyperglycaemic agents. These observations raise the possibility that SGLT2 inhibitors could reduce morbidity and mortality in patients with established heart failure, including those without diabetes. The EMPEROR-Reduced trial is enrolling ≈3600 patients with heart failure and a reduced left ventricular ejection fraction (≤ 40%), half of whom are expected not to have diabetes. Patients are being randomized to placebo or empagliflozin 10 mg daily, which is added to all appropriate treatment with inhibitors of the renin-angiotensin system and neprilysin, beta-blockers and mineralocorticoid receptor antagonists. The primary endpoint is the time-to-first event analysis of the combined risk of cardiovascular death and hospitalization for heart failure, but the trial will also evaluate the effects of empagliflozin on renal function, cardiovascular death, all-cause mortality, and recurrent hospitalization events. By adjusting eligibility based on natriuretic peptide levels to the baseline ejection fraction, the trial will preferentially enrol high-risk patients. A large proportion of the participants is expected to have an ejection fraction

Published
2019
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16. Polypill Strategy in Secondary Cardiovascular Prevention.

Author

Castellano, J. M., Pocock, S. J., Bhatt, D. L., Quesada, A. J., Owen, R., Fernandez-Ortiz, A., Sanchez, P. L., Marin Ortuño, F., Vazquez Rodriguez, J. M., Domingo-Fernández, A., Lozano, I., Roncaglioni, M. C., Baviera, M., Foresta, A., Ojeda-Fernandez, L., Colivicchi, F., Di Fusco, S. A., Doehner, W., Meyer, A., and Schiele, F.

Abstract

BACKGROUND A polypill that includes key medications associated with improved outcomes (aspirin, angiotensin-converting-enzyme [ACE] inhibitor, and statin) has been proposed as a simple approach to the secondary prevention of cardiovascular death and complications after myocardial infarction. METHODS In this phase 3, randomized, controlled clinical trial, we assigned patients with myocardial infarction within the previous 6 months to a polypill-based strategy or usual care. The polypill treatment consisted of aspirin (100 mg), ramipril (2.5, 5, or 10 mg), and atorvastatin (20 or 40 mg). The primary composite outcome was cardiovascular death, nonfatal type 1 myocardial infarction, nonfatal ischemic stroke, or urgent revascularization. The key secondary end point was a composite of cardiovascular death, nonfatal type 1 myocardial infarction, or nonfatal ischemic stroke. RESULTS A total of 2499 patients underwent randomization and were followed for a median of 36 months. A primary-outcome event occurred in 118 of 1237 patients (9.5%) in the polypill group and in 156 of 1229 (12.7%) in the usual-care group (hazard ratio, 0.76; 95% confidence interval [CI], 0.60 to 0.96; P=0.02). A key secondary-outcome event occurred in 101 patients (8.2%) in the polypill group and in 144 (11.7%) in the usual-care group (hazard ratio, 0.70; 95% CI, 0.54 to 0.90; P=0.005). The results were consistent across prespecified subgroups. Medication adherence as reported by the patients was higher in the polypill group than in the usual-care group. Adverse events were similar between groups. CONCLUSIONS Treatment with a polypill containing aspirin, ramipril, and atorvastatin within 6 months after myocardial infarction resulted in a significantly lower risk of major adverse cardiovascular events than usual care. (Funded by the European Union Horizon 2020; SECURE ClinicalTrials.gov number, NCT02596126; EudraCT number, 2015-002868-17.) [ABSTRACT FROM AUTHOR]

Published
2022
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23. Evaluation of the effect of sodium–glucose co-transporter 2 inhibition with empagliflozin on morbidity and mortality of patients with chronic heart failure and a reduced ejection fraction: rationale for and design of the EMPEROR-Reduced trial

Author

Packer, M, Butler, J, Filippatos, G, Jamal, W, Salsali, A, Schnee, J, Kimura, K, Zeller, C, George, J, Brueckmann, M, Anker, S, Zannad, F, Perrone, S, Nicholls, S, Janssens, S, Bocchi, E, Giannetti, N, Verma, S, Jian, Z, Spinar, J, Seronde, M, Bohm, M, Merkely, B, Chopra, V, Senni, M, Taddei, S, Tsutsui, H, Choi, D, Chuquiure, E, La Rocca, H, Ponikowski, P, Juanatey, J, Squire, I, Januzzi, J, Pina, I, Pocock, S, Carson, P, Doehner, W, Miller, A, Haas, M, Pehrson, S, Komajda, M, Anand, I, Teerlink, J, Rabinstein, A, Steiner, T, Kamel, H, Tsivgoulis, G, Lewis, J, Freston, J, Kaplowitz, N, Mann, J, Petrie, M, Bernstein, R, Cheung, A, Green, J, Kaul, S, Ping, C, Lip, G, Marx, N, Mccullough, P, Mehta, C, Rosenstock, J, Sattar, N, Scirica, B, Wanner, C, Welty, F, Parhofer, K, Clayton, T, Pedersen, T, Lees, K, Konstam, M, Greenberg, B, Palmer, M, Packer M., Butler J., Filippatos G. S., Jamal W., Salsali A., Schnee J., Kimura K., Zeller C., George J., Brueckmann M., Anker S. D., Zannad F., Perrone S., Nicholls S., Janssens S., Bocchi E., Giannetti N., Verma S., Jian Z., Spinar J., Seronde M. -F., Bohm M., Merkely B., Chopra V., Senni M., Taddei S., Tsutsui H., Choi D. -J., Chuquiure E., La Rocca H. P. B., Ponikowski P., Juanatey J. R. G., Squire I., Januzzi J., Pina I., Pocock S. J., Carson P., Doehner W., Miller A., Haas M., Pehrson S., Komajda M., Anand I., Teerlink J., Rabinstein A., Steiner T., Kamel H., Tsivgoulis G., Lewis J., Freston J., Kaplowitz N., Mann J., Petrie M., Bernstein R., Cheung A., Green J., Kaul S., Ping C. L. S., Lip G., Marx N., McCullough P., Mehta C., Rosenstock J., Sattar N., Scirica B., Wanner C., Welty F. K., Parhofer K. G., Clayton T., Pedersen T. R., Lees K. R., Konstam M. A., Greenberg B., Palmer M., Packer, M, Butler, J, Filippatos, G, Jamal, W, Salsali, A, Schnee, J, Kimura, K, Zeller, C, George, J, Brueckmann, M, Anker, S, Zannad, F, Perrone, S, Nicholls, S, Janssens, S, Bocchi, E, Giannetti, N, Verma, S, Jian, Z, Spinar, J, Seronde, M, Bohm, M, Merkely, B, Chopra, V, Senni, M, Taddei, S, Tsutsui, H, Choi, D, Chuquiure, E, La Rocca, H, Ponikowski, P, Juanatey, J, Squire, I, Januzzi, J, Pina, I, Pocock, S, Carson, P, Doehner, W, Miller, A, Haas, M, Pehrson, S, Komajda, M, Anand, I, Teerlink, J, Rabinstein, A, Steiner, T, Kamel, H, Tsivgoulis, G, Lewis, J, Freston, J, Kaplowitz, N, Mann, J, Petrie, M, Bernstein, R, Cheung, A, Green, J, Kaul, S, Ping, C, Lip, G, Marx, N, Mccullough, P, Mehta, C, Rosenstock, J, Sattar, N, Scirica, B, Wanner, C, Welty, F, Parhofer, K, Clayton, T, Pedersen, T, Lees, K, Konstam, M, Greenberg, B, Palmer, M, Packer M., Butler J., Filippatos G. S., Jamal W., Salsali A., Schnee J., Kimura K., Zeller C., George J., Brueckmann M., Anker S. D., Zannad F., Perrone S., Nicholls S., Janssens S., Bocchi E., Giannetti N., Verma S., Jian Z., Spinar J., Seronde M. -F., Bohm M., Merkely B., Chopra V., Senni M., Taddei S., Tsutsui H., Choi D. -J., Chuquiure E., La Rocca H. P. B., Ponikowski P., Juanatey J. R. G., Squire I., Januzzi J., Pina I., Pocock S. J., Carson P., Doehner W., Miller A., Haas M., Pehrson S., Komajda M., Anand I., Teerlink J., Rabinstein A., Steiner T., Kamel H., Tsivgoulis G., Lewis J., Freston J., Kaplowitz N., Mann J., Petrie M., Bernstein R., Cheung A., Green J., Kaul S., Ping C. L. S., Lip G., Marx N., McCullough P., Mehta C., Rosenstock J., Sattar N., Scirica B., Wanner C., Welty F. K., Parhofer K. G., Clayton T., Pedersen T. R., Lees K. R., Konstam M. A., Greenberg B., and Palmer M.

Abstract

Drugs that inhibit the sodium–glucose co-transporter 2 (SGLT2) have been shown to reduce the risk of hospitalizations for heart failure in patients with type 2 diabetes. In populations that largely did not have heart failure at the time of enrolment, empagliflozin, canagliflozin and dapagliflozin decreased the risk of serious new-onset heart failure events by ≈30%. In addition, in the EMPA-REG OUTCOME trial, empagliflozin reduced the risk of both pump failure and sudden deaths, the two most common modes of death among patients with heart failure. In none of the three trials could the benefits of SGLT2 inhibitors on heart failure be explained by the actions of these drugs as diuretics or anti-hyperglycaemic agents. These observations raise the possibility that SGLT2 inhibitors could reduce morbidity and mortality in patients with established heart failure, including those without diabetes. The EMPEROR-Reduced trial is enrolling ≈3600 patients with heart failure and a reduced left ventricular ejection fraction (≤ 40%), half of whom are expected not to have diabetes. Patients are being randomized to placebo or empagliflozin 10 mg daily, which is added to all appropriate treatment with inhibitors of the renin–angiotensin system and neprilysin, beta-blockers and mineralocorticoid receptor antagonists. The primary endpoint is the time-to-first event analysis of the combined risk of cardiovascular death and hospitalization for heart failure, but the trial will also evaluate the effects of empagliflozin on renal function, cardiovascular death, all-cause mortality, and recurrent hospitalization events. By adjusting eligibility based on natriuretic peptide levels to the baseline ejection fraction, the trial will preferentially enrol high-risk patients. A large proportion of the participants is expected to have an ejection fraction < 30%, and the estimated annual event rate is expected to be at least 15%. The EMPEROR-Reduced trial is well-positioned to determine if the addi

Published
2019

24. Evaluation of the effects of sodium–glucose co-transporter 2 inhibition with empagliflozin on morbidity and mortality in patients with chronic heart failure and a preserved ejection fraction: rationale for and design of the EMPEROR-Preserved Trial

Author

Anker, S, Butler, J, Filippatos, G, Jamal, W, Salsali, A, Schnee, J, Kimura, K, Zeller, C, George, J, Brueckmann, M, Zannad, F, Packer, M, Perrone, S, Nicholls, S, Janssens, S, Bocchi, E, Giannetti, N, Verma, S, Jian, Z, Gomez Mesa, J, Spinar, J, Bohm, M, Merkely, B, Chopra, V, Senni, M, Taddi, S, Tsutsui, H, Chuquiure, E, La Rocca, H, Ponikowski, P, Vinereanu, D, Sim, D, Choi, D, Juanatey, J, Squire, I, Januzzi, J, Pina, I, Pocock, S, Carson, P, Doehner, W, Miller, A, Haas, M, Pehrson, S, Komajda, M, Anand, I, Teerlink, J, Rabinstein, A, Steiner, T, Kamel, H, Tsivgoulis, G, Lewis, J, Freston, J, Kaplowitz, N, Mann, J, Petrie, M, Bernstein, R, Cheung, A, Green, J, Kaul, S, Ping, C, Lip, G, Marx, N, Mccullough, P, Mehta, C, Rosenstock, J, Sattar, N, Scirica, B, Wanner, C, Welty, F, Parhofer, K, Clayton, T, Pedersen, T, Lees, K, Konstam, M, Greenberg, B, Palmer, M, Anker S. D., Butler J., Filippatos G. S., Jamal W., Salsali A., Schnee J., Kimura K., Zeller C., George J., Brueckmann M., Zannad F., Packer M., Perrone S., Nicholls S., Janssens S., Bocchi E., Giannetti N., Verma S., Jian Z., Gomez Mesa J. E., Spinar J., Bohm M., Merkely B., Chopra V., Senni M., Taddi S., Tsutsui H., Chuquiure E., La Rocca H. P. B., Ponikowski P., Vinereanu D., Sim D., Choi D. -J., Juanatey J. R. G., Squire I., Januzzi J., Pina I., Pocock S. J., Carson P., Doehner W., Miller A., Haas M., Pehrson S., Komajda M., Anand I., Teerlink J., Rabinstein A., Steiner T., Kamel H., Tsivgoulis G., Lewis J., Freston J., Kaplowitz N., Mann J., Petrie M., Bernstein R., Cheung A., Green J., Kaul S., Ping C. L. S., Lip G., Marx N., McCullough P., Mehta C., Rosenstock J., Sattar N., Scirica B., Wanner C., Welty F. K., Parhofer K. G., Clayton T., Pedersen T. R., Lees K. R., Konstam M. A., Greenberg B., Palmer M., Anker, S, Butler, J, Filippatos, G, Jamal, W, Salsali, A, Schnee, J, Kimura, K, Zeller, C, George, J, Brueckmann, M, Zannad, F, Packer, M, Perrone, S, Nicholls, S, Janssens, S, Bocchi, E, Giannetti, N, Verma, S, Jian, Z, Gomez Mesa, J, Spinar, J, Bohm, M, Merkely, B, Chopra, V, Senni, M, Taddi, S, Tsutsui, H, Chuquiure, E, La Rocca, H, Ponikowski, P, Vinereanu, D, Sim, D, Choi, D, Juanatey, J, Squire, I, Januzzi, J, Pina, I, Pocock, S, Carson, P, Doehner, W, Miller, A, Haas, M, Pehrson, S, Komajda, M, Anand, I, Teerlink, J, Rabinstein, A, Steiner, T, Kamel, H, Tsivgoulis, G, Lewis, J, Freston, J, Kaplowitz, N, Mann, J, Petrie, M, Bernstein, R, Cheung, A, Green, J, Kaul, S, Ping, C, Lip, G, Marx, N, Mccullough, P, Mehta, C, Rosenstock, J, Sattar, N, Scirica, B, Wanner, C, Welty, F, Parhofer, K, Clayton, T, Pedersen, T, Lees, K, Konstam, M, Greenberg, B, Palmer, M, Anker S. D., Butler J., Filippatos G. S., Jamal W., Salsali A., Schnee J., Kimura K., Zeller C., George J., Brueckmann M., Zannad F., Packer M., Perrone S., Nicholls S., Janssens S., Bocchi E., Giannetti N., Verma S., Jian Z., Gomez Mesa J. E., Spinar J., Bohm M., Merkely B., Chopra V., Senni M., Taddi S., Tsutsui H., Chuquiure E., La Rocca H. P. B., Ponikowski P., Vinereanu D., Sim D., Choi D. -J., Juanatey J. R. G., Squire I., Januzzi J., Pina I., Pocock S. J., Carson P., Doehner W., Miller A., Haas M., Pehrson S., Komajda M., Anand I., Teerlink J., Rabinstein A., Steiner T., Kamel H., Tsivgoulis G., Lewis J., Freston J., Kaplowitz N., Mann J., Petrie M., Bernstein R., Cheung A., Green J., Kaul S., Ping C. L. S., Lip G., Marx N., McCullough P., Mehta C., Rosenstock J., Sattar N., Scirica B., Wanner C., Welty F. K., Parhofer K. G., Clayton T., Pedersen T. R., Lees K. R., Konstam M. A., Greenberg B., and Palmer M.

Abstract

Background: The principal biological processes that characterize heart failure with a preserved ejection fraction (HFpEF) are systemic inflammation, epicardial adipose tissue accumulation, coronary microcirculatory rarefaction, myocardial fibrosis and vascular stiffness; the resulting impairment of left ventricular and aortic distensibility (especially when accompanied by impaired glomerular function and sodium retention) causes increases in cardiac filling pressures and exertional dyspnoea despite the relative preservation of left ventricular ejection fraction. Independently of their actions on blood glucose, sodium–glucose co-transporter 2 (SGLT2) inhibitors exert a broad range of biological effects (including actions to inhibit cardiac inflammation and fibrosis, antagonize sodium retention and improve glomerular function) that can ameliorate the pathophysiological derangements in HFpEF. Such SGLT2 inhibitors exert favourable effects in experimental models of HFpEF and have been found in large-scale trials to reduce the risk for serious heart failure events in patients with type 2 diabetes, many of whom were retrospectively identified as having HFpEF. Study design: The EMPEROR-Preserved Trial is enrolling ≈5750 patients with HFpEF (ejection fraction >40%), with and without type 2 diabetes, who are randomized to receive placebo or empagliflozin 10 mg/day, which is added to all appropriate treatments for HFpEF and co-morbidities. Study aims: The primary endpoint is the time-to-first-event analysis of the combined risk for cardiovascular death or hospitalization for heart failure. The trial will also evaluate the effects of empagliflozin on renal function, cardiovascular death,. all-cause mortality and recurrent hospitalization events, and will assess a wide range of biomarkers that reflect important pathophysiological mechanisms that may drive the evolution of HFpEF. The EMPEROR-Preserved Trial is well positioned to determine if empagliflozin can have a meaningfu

Published
2019

29. P1932Predictors of DAPT use in patients beyond 1 year post myocardial infarction: Insights from the TIGRIS observational study

Author

Russo, J J, primary, Yan, A T, additional, Pocock, S J, additional, Brieger, D, additional, Owen, R, additional, Andersson Sundell, K, additional, Granger, C B, additional, Cohen, M G, additional, Yasuda, S, additional, Nicolau, J C, additional, Brandrup-Wognsen, G, additional, Westermann, D, additional, Simon, T, additional, and Goodman, S G, additional

Published
2019
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