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1. Cardiology Encounters for Underrepresented Racial and Ethnic Groups with Human Immunodeficiency Virus and Borderline Cardiovascular Disease Risk

Author

Bloomfield, Gerald S., Hill, C. Larry, Chiswell, Karen, Cooper, Linda, Gray, Shamea, Longenecker, Chris T., Louzao, Darcy, Marsolo, Keith, Meissner, Eric G., Morse, Caryn G., Muiruri, Charles, Thomas, Kevin L., Velazquez, Eric J., Vicini, Joseph, Pettit, April C., Sanders, Gretchen, and Okeke, Nwora Lance

Published
2024
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3. Long-term results of surgical ventricular reconstruction and comparison with the Surgical Treatment for Ischemic Heart Failure trial

Author

Gaudino, Mario, Castelvecchio, Serenella, Rahouma, Mohamed, Robinson, N. Bryce, Audisio, Katia, Soletti, Giovanni J., Cancelli, Gianmarco, Tam, Derrick Y., Garatti, Andrea, Benedetto, Umberto, Doenst, Torsten, Girardi, Leonard N., Michler, Robert E., Fremes, Stephen E., Velazquez, Eric J., and Menicanti, Lorenzo

Published
2024
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7. A phenomapping-derived tool to personalize the selection of anatomical vs. functional testing in evaluating chest pain (ASSIST).

Author

Oikonomou, Evangelos K, Van Dijk, David, Parise, Helen, Suchard, Marc A, de Lemos, James, Antoniades, Charalambos, Velazquez, Eric J, Miller, Edward J, and Khera, Rohan

Subjects
Biomedical Imaging, Clinical Research, Heart Disease, Heart Disease - Coronary Heart Disease, Chronic Pain, Pain Research, Patient Safety, Cardiovascular, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Generic health relevance, Good Health and Well Being, Chest Pain, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Humans, Prospective Studies, Chest pain, Phenomapping, Machine learning, Computed tomography, Stress testing, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Cardiovascular System & Hematology
Abstract

AimsCoronary artery disease is frequently diagnosed following evaluation of stable chest pain with anatomical or functional testing. A more granular understanding of patient phenotypes that benefit from either strategy may enable personalized testing.Methods and resultsUsing participant-level data from 9572 patients undergoing anatomical (n = 4734) vs. functional (n = 4838) testing in the PROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain) trial, we created a topological representation of the study population based on 57 pre-randomization variables. Within each patient's 5% topological neighbourhood, Cox regression models provided individual patient-centred hazard ratios for major adverse cardiovascular events and revealed marked heterogeneity across the phenomap [median 1.11 (10th to 90th percentile: 0.52-2.61]), suggestive of distinct phenotypic neighbourhoods favouring anatomical or functional testing. Based on this risk phenomap, we employed an extreme gradient boosting algorithm in 80% of the PROMISE population to predict the personalized benefit of anatomical vs. functional testing using 12 model-derived, routinely collected variables and created a decision support tool named ASSIST (Anatomical vs. Stress teSting decIsion Support Tool). In both the remaining 20% of PROMISE and an external validation set consisting of patients from SCOT-HEART (Scottish COmputed Tomography of the HEART Trial) undergoing anatomical-first vs. functional-first assessment, the testing strategy recommended by ASSIST was associated with a significantly lower incidence of each study's primary endpoint (P = 0.0024 and P = 0.0321 for interaction, respectively), as well as a harmonized endpoint of all-cause mortality or non-fatal myocardial infarction (P = 0.0309 and P

Published
2021

17. Diastolic Dysfunction in Patients With Human Immunodeficiency Virus Receiving Antiretroviral Therapy: Results From the CHART Study

Author

Butler, Javed, Greene, Stephen J, Shah, Svati H, Shah, Sanjiv J, Anstrom, Kevin J, Kim, Raymond J, Kalogeropoulos, Andreas P, Velazquez, Eric J, Hernandez, Adrian F, Desvigne-Nickens, Patrice, Scherzer, Rebecca, Hsue, Priscilla Y, and Braunwald, Eugene

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, HIV/AIDS, Cardiovascular, Infectious Diseases, Clinical Research, Heart Disease, Aetiology, 2.1 Biological and endogenous factors, Cardiomyopathies, Case-Control Studies, Cross-Sectional Studies, HIV, HIV Infections, Heart Atria, Heart Failure, Humans, Quality of Life, Ventricular Dysfunction, Left, Antiretroviral therapy, diastolic dysfunction, human immunodeficiency virus, myocardial fibrosis, Cardiorespiratory Medicine and Haematology, Nursing, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

BackgroundDiastolic dysfunction (DD) is common and occurs at an earlier age among human immunodeficiency virus-infected (HIV+) individuals, but the mechanisms and consequences of DD among HIV+ individuals are unclear.Methods and resultsThe Characterization of Heart Function on Antiretroviral Therapy (CHART) study was a multicenter cross-sectional case-control study of treated and virally suppressed HIV+ individuals with (DD+) and without DD (DD-). All patients had normal ejection fraction (>50%), no significant valvular disease, and no history of coronary revascularization or persistent atrial fibrillation. Overall, 94 DD+ and 101 DD- patients were included. DD+ patients were older with higher body mass index (BMI) and more likely to have hypertension, renal dysfunction, and dyslipidemia. Groups were similar with respect to sex, race, CD4 count, and HIV RNA copies. N-terminal pro-B-type natriuretic peptide levels (median 36 [23, 85] vs 26 [12, 49] pg/mL, P < .01) and high-sensitivity troponin I (3.6 [2.6, 5.1] vs 2.5 [1.8, 3.5] pg/mL, P < .01) were higher among DD+ patients. The latter had similar left atrial size, but increased stiffness (conduit strain: 23.5 [17.5, 36.9] vs 30.0 [22.9, 37.0], P < .01) and impaired relaxation (reservoir strain: 39.7 [32.0, 58.0] vs 45.9 [37.0, 60.6], P = .04). On cardiac magnetic resonance, the prevalence of focal fibrosis was higher among DD+ patients (19.0% vs 5.3%, P < .01). DD+ patients demonstrated higher levels of carboxyl-terminal telopeptide of collagen type I (P = .04), and trends toward higher interleukin-6 and oxidized low-density lipoprotein levels (P ≤ .08). Kansas City Cardiomyopathy Questionnaire physical limitation (87.1±21.4 vs 93.1±18.1, P = .01) and symptom frequency scores were lower among DD+ patients (86.0±21.5 vs 92.5±16.8, P = .01).ConclusionsIn this contemporary HIV+ population receiving antiretroviral therapy, DD was associated with multiple alterations in cardiac structure and function, including myocardial fibrosis and left atrial abnormalities, and worse quality of life. Further studies are needed to assess longitudinal changes in these parameters and their potential as therapeutic targets to prevent progressive cardiac remodeling and dysfunction in HIV.

Published
2020

18. Representativeness of the PIONEER-HF Clinical Trial Population in Patients Hospitalized With Heart Failure and Reduced Ejection Fraction

Author

Fudim, Marat, Sayeed, Sabina, Xu, Haolin, Matsouaka, Roland A, Heidenreich, Paul A, Velazquez, Eric J, Yancy, Clyde W, Fonarow, Gregg C, Hernandez, Adrian F, and DeVore, Adam D

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Cardiovascular, Heart Disease, Clinical Research, Good Health and Well Being, Aged, Aged, 80 and over, Aminobutyrates, Angiotensin II Type 1 Receptor Blockers, Biomarkers, Biphenyl Compounds, Clinical Decision-Making, Drug Combinations, Eligibility Determination, Evidence-Based Medicine, Female, Heart Failure, Humans, Male, Middle Aged, Natriuretic Peptide, Brain, Neprilysin, Patient Admission, Patient Selection, Peptide Fragments, Protease Inhibitors, Randomized Controlled Trials as Topic, Recovery of Function, Registries, Risk Factors, Stroke Volume, Tetrazoles, Time Factors, Treatment Outcome, Valsartan, Ventricular Function, Left, brain natriuretic peptide, enalapril, heart failure, hospitalization, sacubitril valsartan, Biochemistry and Cell Biology, Cardiorespiratory Medicine and Haematology, Medical Physiology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Medical physiology
Abstract

BackgroundIn PIONEER-HF (Comparison of Sacubitril/Valsartan Versus Enalapril on Effect on NT-pro BNP in Patients Stabilized From an Acute Heart Failure Episode), the in-hospital initiation of sacubitril/valsartan in patients hospitalized for acute decompensated heart failure (ADHF) was well-tolerated and led to improved outcomes. We aim to determine the representativeness of the PIONEER-HF trial among patients hospitalized for ADHF using real-world data.MethodsThe study population was derived from all patients discharged alive for ADHF in the Get With The Guidelines-HF registry from 2006 to 2018 with HF with reduced ejection fraction (HFrEF; all HFrEF with ADHF). We then determined the proportion of patients meeting PIONEER-HF eligibility criteria (PIONEER-HF eligible) and those meeting a set of limited eligibility criteria (actionable cohort). Rates of HF readmissions and all-cause mortality were then compared between the all HFrEF with ADHF, PIONEER-HF eligible, and actionable cohorts using linked Medicare claims data.ResultsA total of 99 767 patients with HFrEF in Get With The Guidelines-HF were hospitalized for ADHF. PIONEER-HF inclusion criteria were met by 71 633 (71.8%) patients, and both inclusion and exclusion criteria were met by 20 704 (20.8%) patients. Further, 68 739 (68.9%) patients met the criteria for the actionable cohort. Among the Centers for Medicare and Medicaid-linked patients, the HF rehospitalization rate at 1 year was 35.1% (95% CI, 34.5-35.8) for all HFrEF with ADHF patients, 32.6% (95% CI, 31.3-33.9) for the PIONEER-HF eligible cohort, and 33.1% (95% CI, 32.3-33.9) for the actionable cohort. The 1-year all-cause mortality was 36.7% (95% CI, 36.1-7.4) for all HFrEF with ADHF patients, 31.6% (95% CI, 30.3-32.9) for the PIONEER-HF eligible cohort, and 32.2% (95% CI, 31.4-33.0) for the actionable cohort.ConclusionsPatient characteristics and clinical outcomes for patients eligible for PIONEER-HF only modestly differ when compared with those encountered in routine practice, suggesting that the in-hospital initiation of sacubitril/valsartan should be routinely considered for patients with HFrEF hospitalized for ADHF.

Published
2020

20. Detection of Left Ventricular Systolic Dysfunction From Electrocardiographic Images

Author

Sangha, Veer, Nargesi, Arash A., Dhingra, Lovedeep S., Khunte, Akshay, Mortazavi, Bobak J., Ribeiro, Antônio H., Banina, Evgeniya, Adeola, Oluwaseun, Garg, Nadish, Brandt, Cynthia A., Miller, Edward J., Ribeiro, Antonio Luiz P., Velazquez, Eric J., Giatti, Luana, Barreto, Sandhi M., Foppa, Murilo, Yuan, Neal, Ouyang, David, Krumholz, Harlan M., and Khera, Rohan

Published
2023
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21. Effect of Torsemide Versus Furosemide on Symptoms and Quality of Life Among Patients Hospitalized for Heart Failure: The TRANSFORM-HF Randomized Clinical Trial

Author

Greene, Stephen J., Velazquez, Eric J., Anstrom, Kevin J., Clare, Robert M., DeWald, Tracy A., Psotka, Mitchell A., Ambrosy, Andrew P., Stevens, Gerin R., Rommel, John J., Alexy, Tamas, Ketema, Fassil, Kim, Dong-Yun, Desvigne-Nickens, Patrice, Pitt, Bertram, Eisenstein, Eric L., and Mentz, Robert J.

Published
2023
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22. On‐treatment analysis of torsemide versus furosemide for patients hospitalized for heart failure: A post‐hoc analysis of TRANSFORM‐HF

Author

Kittipibul, Veraprapas, primary, Mentz, Robert J., additional, Clare, Robert M., additional, Wojdyla, Daniel M., additional, Anstrom, Kevin J., additional, Eisenstein, Eric L., additional, Ambrosy, Andrew P., additional, Goyal, Parag, additional, Skopicki, Hal A., additional, Ketema, Fassil, additional, Kim, Dong‐Yun, additional, Desvigne‐Nickens, Patrice, additional, Pitt, Bertram, additional, Velazquez, Eric J., additional, and Greene, Stephen J., additional

Published
2024
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23. Optimal medical therapy with or without surgical revascularization and long-term outcomes in ischemic cardiomyopathy

Author

Dabrowski, Rafal, Djokovic, Ljubomir, Drazner, Mark, Haddad, Haissam, Ali, Imtiaz S., Keltai, Matyas, Naik, Ajay, Sopko, George, Golba, Krzysztof, Andersson, Bert, Carson, Peter, Kukulski, Tomasz, Farsky, Pedro S., White, Jennifer, Al-Khalidi, Hussein R., Sueta, Carla A., Rouleau, Jean L., Panza, Julio A., Velazquez, Eric J., and O'Connor, Christopher M.

Published
2022
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27. Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF)

Author

Ghazi, Lama, Desai, Nihar R., Simonov, Michael, Yamamoto, Yu, O'Connor, Kyle D., Riello, Ralph J., Huang, Joanna, Olufade, Temitope, McDermott, James, Inzucchi, Silvio E., Velazquez, Eric J., Wilson, F. Perry, and Ahmad, Tariq

Published
2022
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28. Diastolic Dysfunction in Individuals With Human Immunodeficiency Virus Infection: Literature Review, Rationale and Design of the Characterizing Heart Function on Antiretroviral Therapy (CHART) Study

Author

Butler, Javed, Kalogeropoulos, Andreas P, Anstrom, Kevin J, Hsue, Priscilla Y, Kim, Raymond J, Scherzer, Rebecca, Shah, Sanjiv J, Shah, Svati H, Velazquez, Eric J, Hernandez, Adrian F, Desvigne-Nickens, Patrice, and Braunwald, Eugene

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Immunology, Infectious Diseases, Cardiovascular, HIV/AIDS, Clinical Research, Heart Disease, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, 2.1 Biological and endogenous factors, Aetiology, Infection, Good Health and Well Being, Anti-Retroviral Agents, Global Health, HIV, HIV Infections, Heart Failure, Diastolic, Humans, Incidence, Prognosis, Stroke Volume, Ventricular Function, Left, Human immunodeficiency virus, diastolic dysfunction, heart failure, pathophysiology, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Nursing, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

Antiretroviral therapy (ART) has been associated with a shift in the epidemiology of human immunodeficiency virus (HIV)-associated cardiomyopathy from a phenotype of primarily left ventricular (LV) systolic dysfunction to LV diastolic dysfunction (DD). Patients with HIV receiving ART have higher rates of DD compared with age-matched control subjects and develop DD at a younger age. However, little is known about the natural history and pathogenesis of DD in virally suppressed HIV-infected patients. Current evidence suggests that immune processes modulate the risk for cardiac involvement in HIV-infected persons. Ongoing inflammation appears to have myocardial effects, and accelerated myocardial fibrosis appears to be a key mediator of HIV-induced DD. The Characterizing Heart Function on Antiretroviral Therapy (CHART) study aims to systematically investigate determinants, mechanisms, and consequences of DD in HIV-infected patients. We will compare ART-treated virally suppressed HIV-infected individuals with and without DD and HIV- individuals with DD regarding (1) systemic inflammation, myocardial stress, and subclinical myocardial necrosis as indicated by circulating biomarkers; (2) immune system activation as indicated by cell surface receptors; (3) myocardial fibrosis according to cardiac magnetic resonance examination; (4) markers of fibrosis and remodeling, oxidative stress, and hypercoagulability; (5) left atrial function according to echocardiographic examination; (6) myocardial stress and subclinical necrosis as indicated by circulating biomarkers; (7) proteomic and metabolic profiles; and (8) phenotype signatures derived from clinical, biomarker, and imaging data.

Published
2018

29. The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial

Author

CHOUAIRI, FOUAD, FUERY, MICHAEL A., MULLAN, CLANCY W., CARABALLO, CESAR, SEN, SOUNOK, MAULION, CHRISTOPHER, WILKINSON, SAMUEL T., SURTI, TORAL, MCCULLOUGH, MEGAN, MILLER, P. ELLIOTT, PACOR, JUSTIN, LEIFER, ERIC S., FELKER, G. MICHAEL, VELAZQUEZ, ERIC J., FIUZAT, MONA, O'CONNOR, CHRISTOPHER M., JANUZZI, JAMES L, DESAI, NIHAR R., and AHMAD, TARIQ

Published
2021
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33. Abstract 13818: Health System Integrated Measurement-Based Care Using Patient-Reported Outcomes Assessment in Lower-Extremity Peripheral Artery Disease

Author

Smolderen, Kim G, Scierka, Lindsey, Rahman, Mufti, van Roij, Evy, Bradley, Brooklyn, Nagpal, Sameer, Spertus, John, Bascombe, Alexandria, Siddiqui, Waleed Tariq, Provance, Jeremy A, Romain, Gaelle, Lynch, Shannon, Bogra, Pragati, Velazquez, Eric J, Churchwell, Keith, Lorusso, Francine, and Mena-Hurtado, Carlos

Published
2022
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38. Pragmatic Design of Randomized Clinical Trials for Heart Failure: Rationale and Design of the TRANSFORM-HF Trial

Author

Adams, Kirkwood, Long, Tammy, Bhatt, Kunal, Walker, Brandon, DeWald, Tracy, Biever, Kim, Axsom, Kelly, Acosta, Ariana, Murthy, Sandhya, Camilo, Angeline, Rich, Jonathan D., Martinez, Leslie, Testani, Jeffrey M., Tainsh, Jennifer, Smith, Bryan, Bennett, Amy, Vader, Justin, Stilinovic, Stephanie, McCulloch, Michael, Musso, Iris, Skopicki, Hal, Caikauskaite, Indre, Psotka, Mitchell A., Freiler, Allen, Heroux, Alain, Kartje, Carol, Lala-Trindade, Anuradha, Julien, Lovelyne, Stevens, Gerin, Leppla, Keriann, Tang, Wilson, Fonk, Teresa, Lev, Yair, Fizgerald, Kathleen, William, Preethi, Stroster, John, Eberly, Arthur, III, Workman, Celeste, Gottlieb, Stephen, Bowers-Lash, Mary, Haught, Walter Herbert, Abath, Cynthia, Grafton, Gillian, Neaton, Kelsey, Larned, Joshua, Ortiz, Mara-Li, Tejwani, Lokesh, Villalta, Tara, Mody, Freny, Strugatsky, Svetlana, Krim, Selim, Washington, Katasha, Robinson, Monique, Norton, Nadine, Smart, Frank, Worsham, Emily, Fang, James, Goldstein, Joe, Dunlap, Stephanie, Starnes, Nancy, Adler, Alexander, Theodorof, Virginia, Bell, Adrian, Kondramashin, Aleksey, Banerjee, Dipanjan, Yee, Michael, Ruiz-Duque, Ernesto, Larew, Cynthia, Mizyed, Ahmad, Sawaya, Kara, Friedman, Dennis, Rele, Shilpa, Rommel, John, Burkhart, Janet, Arhinful, Justice, Atkinson, Sam, Goyal, Parag, Samdani, Nidha, Hall, Michael, Watson, Connie, Hummel, Scott, Wells, Joanna, Shetty, Sanjay, White, Jackie, Haas, Donald, Marchand, Colleen, Vilaro, Juan, Osman, Alfaroug, Alexy, Tamas, Dicken, Julie, Guglin, Maya, Willig, Meghan, Ferguson, Andrew, Peabody, Mark, Herre, John, McMichael, Brittany, Clark, John, Britton, Nancy, Ambrosy, Andrew P., Tan, Thida, Heitner, John, Meykler, Marcella, Meadows, Judith, Halliday, Janet, Greene, Stephen J., Velazquez, Eric J., Anstrom, Kevin J., Eisenstein, Eric L., Sapp, Shelly, Morgan, Shelby, Harding, Tina, Sachdev, Vandana, Ketema, Fassil, Kim, Dong-Yun, Desvigne-Nickens, Patrice, Pitt, Bertram, and Mentz, Robert J.

Published
2021
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39. Relation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients With Coronavirus Disease 2019 (from the Yale COVID-19 Cardiovascular Registry)

Author

Pareek, Manan, Singh, Avinainder, Vadlamani, Lina, Eder, Maxwell, Pacor, Justin, Park, Jakob, Ghazizadeh, Zaniar, Heard, Alex, Cruz-Solbes, Ana Sofia, Nikooie, Roozbeh, Gier, Chad, Ahmed, Zain V., Freeman, James V., Meadows, Judith, Smolderen, Kim G.E., Lampert, Rachel, Velazquez, Eric J., Ahmad, Tariq, and Desai, Nihar R.

Published
2021
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44. Cardiac effects of deferasirox in transfusion‐dependent patients with myelodysplastic syndromes: TELESTO study.

Author

Sarocchi, Matteo, Li, Junmin, Li, Xiao, Wu, Depei, Montaño Figueroa, Efreen, Rodriguez, Maria Guadalupe, Hou, Ming, Finelli, Carlo, Shi, Hong‐Xia, Xiao, Zhijian, Oliva, Esther Natalie, Gercheva Kyuchukova, Liana, Drummond, Mark, Symeonidis, Argiris, Velazquez, Eric J., Rivoli, Giulia, Izquierdo, Miguel, Kolekar, Yogita, Spallarossa, Paolo, and Angelucci, Emanuele

Subjects
MYELODYSPLASTIC syndromes, IRON overload, FETOFETAL transfusion, DEFERASIROX, CONGESTIVE heart failure, IRON chelates, DIASTOLE (Cardiac cycle)
Abstract

Summary: Iron overload from repeated transfusions has a negative impact on cardiac function, and iron chelation therapy may help prevent cardiac dysfunction in transfusion‐dependent patients with myelodysplastic syndromes (MDS). TELESTO (NCT00940602) was a prospective, placebo‐controlled, randomised study to evaluate the iron chelator deferasirox in patients with low‐ or intermediate‐1–risk MDS and iron overload. Echocardiographic parameters were collected at screening and during treatment. Patients receiving deferasirox experienced a significant decrease in the composite risk of hospitalisation for congestive heart failure (CHF) or worsening of cardiac function (HR = 0.23; 95% CI: 0.05, 0.99; nominal p = 0.0322) versus placebo. No significant differences between the arms were found in left ventricular ejection fraction, ventricular diameter and mass or pulmonary artery pressure. The absolute number of events was low, but the enrolled patients were younger than average for patients with MDS, with no serious cardiac comorbidities and a modest cardiovascular risk profile. These results support the effectiveness of deferasirox in preventing cardiac damage caused by iron overload in this patient population. Identification of patients developing CHF is challenging due to the lack of distinctive echocardiographic features. The treatment of iron overload may be important to prevent cardiac dysfunction in these patients, even those with moderate CHF risk. [ABSTRACT FROM AUTHOR]

Published
2024
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45. Impact of baseline kidney dysfunction on oral diuretic efficacy following hospitalization for heart failure – insights from TRANSFORM‐HF.

Author

Martens, Pieter, Greene, Stephen J., Mentz, Robert J., Li, Shuang, Wojdyla, Daniel, Kapelios, Chris J., Mullens, Wilfried, Hall, Michael E., Ketema, Fassil, Kim, Dong‐Yun, Eisenstein, Eric L., Anstrom, Kevin, Fang, James C., Pitt, Bertram, Velazquez, Eric J., and Tang, W.H. Wilson

Subjects
HEART failure, GLOMERULAR filtration rate, HOSPITAL care, DIURETICS, KIDNEY physiology
Abstract

Aim: Among patients discharged after hospitalization for heart failure (HF), a strategy of torsemide versus furosemide showed no difference in all‐cause mortality or hospitalization. Clinicians have traditionally favoured torsemide in the setting of kidney dysfunction due to better oral bioavailability and longer half‐life, but direct supportive evidence is lacking. Methods and results: The TRANSFORM‐HF trial randomized patients hospitalized for HF to a long‐term strategy of torsemide versus furosemide, and enrolled patients across the spectrum of renal function (without dialysis). In this post‐hoc analysis, baseline renal function during the index hospitalization was assessed as categories of estimated glomerular filtration rate (eGFR; <30, 30–<60, ≥60 ml/min/1.73 m2). The interaction between baseline renal function and treatment effect of torsemide versus furosemide was assessed with respect to mortality and hospitalization outcomes, and the change in Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ‐CSS). Of 2859 patients randomized, 336 (11.8%) had eGFR <30 ml/min/1.73 m2, 1138 (39.8%) had eGFR 30–<60 ml/min/1.73 m2, and 1385 (48.4%) had eGFR ≥60 ml/min/1.73 m2. Baseline eGFR did not modify treatment effects of torsemide versus furosemide on all adverse clinical outcomes including individual components or composites of all‐cause mortality and all‐cause (re)‐hospitalizations, both when assessing eGFR categorically or continuously (p‐value for interaction all >0.108). Similarly, no treatment effect modification by eGFR was found for the change in KCCQ‐CSS (p‐value for interaction all >0.052) when assessing eGFR categorically or continuously. Conclusion: Among patients discharged after hospitalization for HF, there was no significant difference in clinical and patient‐reported outcomes between torsemide and furosemide, irrespective of renal function. [ABSTRACT FROM AUTHOR]

Published
2024
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48. Torsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure

Author

Krim, Selim R., primary, Anand, Senthil, additional, Greene, Stephen J., additional, Chen, Anqi, additional, Wojdyla, Daniel, additional, Vilaro, Juan, additional, Haught, Herbert, additional, Herre, John M., additional, Eisenstein, Eric L., additional, Anstrom, Kevin J., additional, Pitt, Bertram, additional, Velazquez, Eric J., additional, and Mentz, Robert J., additional

Published
2023
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49. Variation in Reader-Reported Severity of Paradoxical Low-Flow Low-Gradient Aortic Stenosis

Author

Shah, Nimish N., primary, Sugeng, Lissa, additional, Zhang, Zhiyuan, additional, Wang, Kangxin, additional, McNamara, Robert L., additional, Agarwal, Vratika, additional, Hur, David J., additional, Lombo, Bernardo, additional, Bellumkonda, Lavanya, additional, Mankbadi, Michael, additional, Basem Dajani, Abdel Rahman, additional, Forrest, John K., additional, Krumholz, Harlan M., additional, Reinhardt, Samuel W., additional, Velazquez, Eric J., additional, and Faridi, Kamil F., additional

Published
2023
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