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1,555 results on '"McMurray, John J. V."'

1. Finerenone in heart failure and chronic kidney disease with type 2 diabetes: FINE-HEART pooled analysis of cardiovascular, kidney and mortality outcomes

Author

Vaduganathan, Muthiah, Filippatos, Gerasimos, Claggett, Brian L., Desai, Akshay S., Jhund, Pardeep S., Henderson, Alasdair, Brinker, Meike, Kolkhof, Peter, Schloemer, Patrick, Lay-Flurrie, James, Viswanathan, Prabhakar, Lam, Carolyn S. P., Senni, Michele, Shah, Sanjiv J., Voors, Adriaan A., Zannad, Faiez, Rossing, Peter, Ruilope, Luis M., Anker, Stefan D., Pitt, Bertram, Agarwal, Rajiv, McMurray, John J. V., and Solomon, Scott D.

Published
2024
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3. Clinical Correlates and Prognostic Impact of Cognitive Dysfunction in Patients With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF

Author

Shen, Li, Dewan, Pooja, Ferreira, João Pedro, Cunningham, Jonathan W., Jhund, Pardeep S., Anand, Inder S., Chandra, Alvin, Chiang, Lu-May, Claggett, Brian, Desai, Akshay S., Gong, Jianjian, Lam, Carolyn S. P., Lefkowitz, Martin P., Maggioni, Aldo P., Martinez, Felipe, Packer, Milton, Redfield, Margaret M., Rouleau, Jean L., van Veldhuisen, Dirk J., Zannad, Faiez, Zile, Michael R., Solomon, Scott D., and McMurray, John J. V.

Published
2024
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4. Author Correction: Finerenone in heart failure and chronic kidney disease with type 2 diabetes: FINE-HEART pooled analysis of cardiovascular, kidney and mortality outcomes

Author

Vaduganathan, Muthiah, Filippatos, Gerasimos, Claggett, Brian L., Desai, Akshay S., Jhund, Pardeep S., Henderson, Alasdair, Brinker, Meike, Kolkhof, Peter, Schloemer, Patrick, Lay-Flurrie, James, Viswanathan, Prabhakar, Lam, Carolyn S. P., Senni, Michele, Shah, Sanjiv J., Voors, Adriaan A., Zannad, Faiez, Rossing, Peter, Ruilope, Luis M., Anker, Stefan D., Pitt, Bertram, Agarwal, Rajiv, McMurray, John J. V., and Solomon, Scott D.

Published
2024
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5. Contemporary epidemiology of hospitalised heart failure with reduced versus preserved ejection fraction in England: a retrospective, cohort study of whole-population electronic health records

Author

Fletcher, Robert A, Rockenschaub, Patrick, Neuen, Brendon L, Walter, Isabel Johanna, Conrad, Nathalie, Mizani, Mehrdad A, Bolton, Thomas, Lawson, Claire A, Tomlinson, Christopher, Logothetis, Stelios Boulitsakis, Petitjean, Carmen, Brizzi, Luigi Filippo, Kaptoge, Stephen, Raffetti, Elena, Calvert, Patrick A, Di Angelantonio, Emanuele, Banerjee, Amitava, Mamas, Mamas A, Squire, Iain, Denaxas, Spiros, McDonagh, Theresa A, Sudlow, Cathie, Petersen, Steffen E, Chertow, Glenn M, Khunti, Kamlesh, Sundström, Johan, Arnott, Clare, Cleland, John G F, Danesh, John, McMurray, John J V, Vaduganathan, Muthiah, and Wood, Angela M

Published
2024
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8. Efficacy and safety of SGLT2 inhibitors with and without glucagon-like peptide 1 receptor agonists: a SMART-C collaborative meta-analysis of randomised controlled trials

Author

Apperloo, Ellen M, Neuen, Brendon L, Fletcher, Robert A, Jongs, Niels, Anker, Stefan D, Bhatt, Deepak L, Butler, Javed, Cherney, David Z I, Herrington, William G, Inzucchi, Silvio E, Jardine, Meg J, Liu, Chih-Chin, Mahaffey, Kenneth W, McGuire, Darren K, McMurray, John J V, Neal, Bruce, Packer, Milton, Perkovic, Vlado, Sabatine, Marc S, Solomon, Scott D, Staplin, Natalie, Szarek, Michael, Vaduganathan, Muthiah, Wanner, Christoph, Wheeler, David C, Wiviott, Stephen D, Zannad, Faiez, and Heerspink, Hiddo J L

Published
2024
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11. Initiation of SGLT2 inhibitors and GLP-1 receptor agonists according to level of frailty in people with type 2 diabetes and cardiovascular disease in Denmark: a cross-sectional, nationwide study

Author

Malik, Mariam Elmegaard, Butt, Jawad Haider, Strange, Jarl Emanuel, Falkentoft, Alexander Christian, Jensen, Jesper, Andersson, Charlotte, Zahir, Deewa, Fosbøl, Emil, Petrie, Mark C, Sattar, Naveed, McMurray, John J V, Køber, Lars, and Schou, Morten

Published
2023
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12. Author Correction: Dapagliflozin in heart failure with improved ejection fraction: a prespecified analysis of the DELIVER trial

Author

Vardeny, Orly, Fang, James C., Desai, Akshay S., Jhund, Pardeep S., Claggett, Brian, Vaduganathan, Muthiah, de Boer, Rudolf A., Hernandez, Adrian F., Lam, Carolyn S. P., Inzucchi, Silvio E., Martinez, Felipe A., Kosiborod, Mikhail N., DeMets, David, O’Meara, Eileen, Zieroth, Shelley, Comin-Colet, Josep, Drozdz, Jaroslaw, Chiang, Chern-En, Kitakaze, Masafumi, Petersson, Magnus, Lindholm, Daniel, Langkilde, Anna Maria, McMurray, John J. V., and Solomon, Scott D.

Published
2023
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13. Dapagliflozin in heart failure with improved ejection fraction: a prespecified analysis of the DELIVER trial

Author

Vardeny, Orly, Fang, James C., Desai, Akshay S., Jhund, Pardeep S., Claggett, Brian, Vaduganathan, Muthiah, de Boer, Rudolf A., Hernandez, Adrian F., Lam, Carolyn S. P., Inzucchi, Silvio E., Martinez, Felipe A., Kosiborod, Mikhail N., DeMets, David, O’Meara, Eileen, Zieroth, Shelley, Comin-Colet, Josep, Drozdz, Jaroslaw, Chiang, Chern-En, Kitakaze, Masafumi, Petersson, Magnus, Lindholm, Daniel, Langkilde, Anna Maria, McMurray, John J. V., and Solomon, Scott D.

Published
2022
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15. Dapagliflozin across the range of ejection fraction in patients with heart failure: a patient-level, pooled meta-analysis of DAPA-HF and DELIVER

Author

Jhund, Pardeep S., Kondo, Toru, Butt, Jawad H., Docherty, Kieran F., Claggett, Brian L., Desai, Akshay S., Vaduganathan, Muthiah, Gasparyan, Samvel B., Bengtsson, Olof, Lindholm, Daniel, Petersson, Magnus, Langkilde, Anna Maria, de Boer, Rudolf A., DeMets, David, Hernandez, Adrian F., Inzucchi, Silvio E., Kosiborod, Mikhail N., Køber, Lars, Lam, Carolyn S. P., Martinez, Felipe A., Sabatine, Marc S., Shah, Sanjiv J., Solomon, Scott D., and McMurray, John J. V.

Published
2022
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18. Efficacy and safety of dapagliflozin in patients with heart failure with mildly reduced or preserved ejection fraction by baseline glycaemic status (DELIVER): a subgroup analysis from an international, multicentre, double-blind, randomised, placebo-controlled trial

Author

Inzucchi, Silvio E, Claggett, Brian L, Vaduganathan, Muthiah, Desai, Akshay S, Jhund, Pardeep S, de Boer, Rudolf A, Hernandez, Adrian F, Kosiborod, Mikhail N, Lam, Carolyn S P, Martinez, Felipe, Shah, Sanjiv J, Verma, Subodh, Han, Yaling, Kerr Saraiva, Jose F, Bengtsson, Olof, Petersson, Magnus, Langkilde, Anna Maria, McMurray, John J V, and Solomon, Scott D

Published
2022
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23. Loop diuretic therapy with or without heart failure: impact on prognosis.

Author

Friday, Jocelyn M, Cleland, John G F, Pellicori, Pierpaolo, Wolters, Maria K, McMurray, John J V, Jhund, Pardeep S, Forsyth, Paul, McAllister, David A, Graham, Fraser J, Jones, Yola, and Lewsey, Jim

Subjects
LEFT heart atrium, COMORBIDITY, DIURETICS, VENTRICULAR ejection fraction, MEDICAL records, HEART failure
Abstract

Background and Aims Many patients are prescribed loop diuretics without a diagnostic record of heart failure. Little is known about their characteristics and prognosis. Methods Glasgow regional health records (2009–16) were obtained for adults with cardiovascular disease or taking loop diuretics. Outcomes were investigated using Cox models with hazard ratios adjusted for age, sex, socioeconomic deprivation, and comorbid disease (adjHR). Results Of 198 898 patients (median age 65 years; 55% women), 161 935 (81%) neither took loop diuretics nor had a diagnostic record of heart failure (reference group), 23 963 (12%) were taking loop diuretics but had no heart failure recorded, 7844 (4%) had heart failure recorded and took loop diuretics, and 5156 (3%) had heart failure recorded but were not receiving loop diuretics. Compared to the reference group, five-year mortality was only slightly higher for heart failure in the absence of loop diuretics [22%; adjHR 1.2 (95% CI 1.1–1.3)], substantially higher for those taking loop diuretics with no record of heart failure [40%; adjHR 1.8 (95% CI 1.7–1.8)], and highest for heart failure treated with loop diuretics [52%; adjHR 2.2 (95% CI 2.0–2.2)]. Conclusions For patients with cardiovascular disease, many are prescribed loop diuretics without a recorded diagnosis of heart failure. Mortality is more strongly associated with loop diuretic use than with a record of heart failure. The diagnosis of heart failure may be often missed, or loop diuretic use is associated with other conditions with a prognosis similar to heart failure, or inappropriate loop diuretic use increases mortality; all might be true. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Dapagliflozin and new-onset type 2 diabetes in patients with chronic kidney disease or heart failure: pooled analysis of the DAPA-CKD and DAPA-HF trials

Author

Rossing, Peter, Inzucchi, Silvio E, Vart, Priya, Jongs, Niels, Docherty, Kieran F, Jhund, Pardeep S, Køber, Lars, Kosiborod, Mikhail N, Martinez, Felipe A, Ponikowski, Piotr, Sabatine, Marc S, Solomon, Scott D, DeMets, David L, Bengtsson, Olof, Lindberg, Magnus, Langkilde, Anna Maria, Sjöstrand, Mikaela, Stefansson, Bergur V, Karlsson, Cecilia, Chertow, Glenn M, Hou, Fan Fan, Correa-Rotter, Ricardo, Toto, Robert D, Wheeler, David C, McMurray, John J V, and Heerspink, Hiddo J L

Published
2022
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26. Prognostic Models for Mortality and Morbidity in Heart Failure With Preserved Ejection Fraction

Author

McDowell, Kirsty, primary, Kondo, Toru, additional, Talebi, Atefeh, additional, Teh, Ken, additional, Bachus, Erasmus, additional, de Boer, Rudolf A., additional, Campbell, Ross T., additional, Claggett, Brian, additional, Desai, Ashkay S., additional, Docherty, Kieran F., additional, Hernandez, Adrian F., additional, Inzucchi, Silvio E., additional, Kosiborod, Mikhail N., additional, Lam, Carolyn S. P., additional, Martinez, Felipe, additional, Simpson, Joanne, additional, Vaduganathan, Muthiah, additional, Jhund, Pardeep S., additional, Solomon, Scott D., additional, and McMurray, John J. V., additional

Published
2024
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27. Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016

Author

Knigge, Pauline, primary, Lundberg, Sørine, additional, Strange, Jarl E., additional, Malik, Mariam E., additional, Nouhravesh, Nina, additional, Wagner, Andrea K., additional, Gislason, Gunnar, additional, Fosbøl, Emil L., additional, Carlson, Nicholas, additional, Zahir, Deewa, additional, Andersson, Charlotte, additional, Butt, Jawad H., additional, Jhund, Pardeep, additional, Petrie, Mark C., additional, McMurray, John J. V., additional, Køber, Lars, additional, and Schou, Morten, additional

Published
2024
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28. Cost Effectiveness of Dapagliflozin for Heart Failure Across the Spectrum of Ejection Fraction: An Economic Evaluation Based on Pooled, Individual Participant Data From the DELIVER and DAPA‐HF Trials

Author

Bhatt, Ankeet S., primary, Vaduganathan, Muthiah, additional, Claggett, Brian L., additional, Kulac, Ian J., additional, Anand, Inder S., additional, Desai, Akshay S., additional, Fang, James C., additional, Hernandez, Adrian F., additional, Jhund, Pardeep S., additional, Kosiborod, Mikhail N., additional, Sabatine, Marc S., additional, Shah, Sanjiv J., additional, Vardeny, Orly, additional, McMurray, John J. V., additional, Solomon, Scott D., additional, and Gaziano, Thomas A., additional

Published
2024
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33. Effects of Sacubitril/Valsartan on All-Cause Hospitalizations in Heart Failure: Post Hoc Analysis of the PARADIGM-HF and PARAGON-HF Randomized Clinical Trials

Author

Lu, Henri, Claggett, Brian L., Packer, Milton, Lam, Carolyn S. P., Swedberg, Karl, Rouleau, Jean, Zile, Michael R., Lefkowitz, Martin, Desai, Akshay S., Jhund, Pardeep, McMurray, John J. V., Solomon, Scott D., and Vaduganathan, Muthiah

Abstract

IMPORTANCE: Sacubitril/valsartan is indicated to reduce the risk of cardiovascular death and heart failure (HF) hospitalizations in patients with chronic HF. However, many of these patients are older and have multiple comorbidities that increase the risk of hospitalization for causes other than HF. OBJECTIVE: To assess the effects of sacubitril/valsartan on hospitalizations of any cause across the spectrum of left ventricular ejection fraction (LVEF). DESIGN, SETTING, AND PARTICIPANTS: This post hoc, participant-level, pooled analysis of the PARADIGM-HF (in patients with an LVEF ≤40%) and PARAGON-HF (in patients with an LVEF ≥45%) randomized clinical trials was conducted from February 5, 2024, to April 5, 2024. Participants with chronic HF, New York Heart Association classes II through IV symptoms, and elevated natriuretic peptides were randomized to treatment with either sacubitril/valsartan or a renin-angiotensin system inhibitor (RASi)—enalapril in the PARADIGM-HF trial or valsartan in the PARAGON-HF trial. INTERVENTION: Sacubitril/valsartan vs RASi (enalapril or valsartan). MAIN OUTCOMES AND MEASURES: The effects of sacubitril/valsartan on time to first investigator-reported all-cause and cause-specific hospitalizations were examined using Cox proportional hazards models, stratified by geographic region and trial. Effect modification by LVEF as a continuous function was examined. RESULTS: Among 13 194 participants in the PARADIGM-HF and PARAGON-HF trials, mean (SD) patient age was 67 (11) years, 8883 patients (67.3%) were male, and mean (SD) LVEF was 40% (15%). Sacubitril/valsartan significantly reduced the risk of all-cause hospitalization (ACH) compared with RASi over a median (IQR) follow-up period of 2.5 (1.8-3.1) years (hazard ratio [HR], 0.92; 95% CI, 0.88-0.97; P = .002). The incidence rate of first ACH was 25 (95% CI, 24-26) per 100 patient-years in the sacubitril/valsartan arm and 27 (95% CI, 26-28) per 100 patient-years in the RASi arm. The absolute risk reduction (ARR) was 2.1 per 100 patient-years, corresponding to a number needed to treat (NNT) of 48 patient-years of treatment exposure to prevent 1 ACH. Reductions in overall hospitalizations seemed primarily driven by lower rates of cardiac and pulmonary hospitalizations with sacubitril/valsartan. Patients in the 2 treatment arms had similar rates of composite noncardiac hospitalizations. Treatment heterogeneity on ACH by LVEF was observed (P for interaction = .03), with benefits most apparent in patients with an LVEF less than 60% (HR, 0.91; 95% CI, 0.86-0.96), but not in patients with an LVEF of 60% or more (HR, 0.97; 95% CI, 0.86-1.09). CONCLUSIONS AND RELEVANCE: In this post hoc pooled analysis of 13 194 patients with chronic HF in the PARADIGM-HF and PARAGON-HF randomized clinical trials, sacubitril/valsartan significantly reduced hospitalization for any reason, with benefits most apparent in patients with an LVEF below normal. This reduction appeared to be principally driven by lower rates of cardiac and pulmonary hospitalizations. TRIAL REGISTRATIONS: ClinicalTrials.gov Identifiers: NCT01035255 (PARADIGM-HF) and NCT01920711 (PARAGON-HF)

Published
2024
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38. Dapagliflozin and Blood Pressure in Patients with Chronic Kidney Disease and Albuminuria

Author

Heerspink, Hiddo J. L., Provenzano, Michele, Vart, Priya, Jongs, Niels, Correa-Rotter, Ricardo, Rossing, Peter, Mark, Patrick B., Pecoits-Filho, Roberto, McMurray, John J. V., Langkilde, Anna Maria, Wheeler, David C., Toto, Robert B., Chertow, Glenn M., Heerspink, Hiddo J. L., Provenzano, Michele, Vart, Priya, Jongs, Niels, Correa-Rotter, Ricardo, Rossing, Peter, Mark, Patrick B., Pecoits-Filho, Roberto, McMurray, John J. V., Langkilde, Anna Maria, Wheeler, David C., Toto, Robert B., and Chertow, Glenn M.

Abstract

BACKGROUND AND AIMS: Sodium-glucose cotransporter 2 inhibitors decrease blood pressure in patients with type 2 diabetes, but the consistency and magnitude of blood pressure lowering with dapagliflozin in patients with chronic kidney disease (CKD) is unknown. We conducted a prespecified analysis of the DAPA-CKD trial to investigate the effect of dapagliflozin on systolic blood pressure (SBP) in patients with CKD, with and without type 2 diabetes.METHODS: A total of 4304 adults with baseline estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73m 2 and urinary albumin-to-creatinine ratio (UACR) 200-5000 mg/g were randomized to either dapagliflozin 10 mg or placebo once daily; median follow-up was 2.4 years. The primary endpoint was a composite of sustained ≥50% eGFR decline, end-stage kidney disease, or death from a kidney or cardiovascular cause. Change in SBP was a prespecified outcome. RESULTS: Baseline mean (SD) SBP was 137.1 mmHg (17.4). By Week 2, dapagliflozin compared to placebo reduced SBP by 3.6 mmHg (95% CI 2.8-4.4 mmHg), an effect maintained over the duration of the trial (2.9 mmHg, 2.3-3.6 mmHg). Time-averaged reductions in SBP were 3.2 mmHg (2.5-4.0 mmHg) in patients with diabetes and 2.3 mmHg (1.2-3.4 mmHg) in patients without diabetes. The time-averaged effect of dapagliflozin on diastolic blood pressure (DBP) was 1.0 mmHg (0.6-1.4 mmHg); 0.8 mmHg (0.4-1.3 mmHg) in patients with diabetes and 1.4 mmHg (0.7-2.1 mmHg) in patients without diabetes. Benefits of dapagliflozin on the primary composite and secondary endpoints were evident across the spectrum of baseline SBP and DBP.CONCLUSION: In patients with CKD and albuminuria, randomization to dapagliflozin was associated with modest reductions in systolic and diastolic BP.

Published
2024

39. Effects of Dapagliflozin in Chronic Kidney Disease Across the Spectrum of Age and by Sex

Author

Yu, Margaret K., Vart, Priya, Jongs, Niels, Correa-Rotter, Ricardo, Rossing, Peter, McMurray, John J. V., Hou, Fan-Fan, Douthat, Walter, Khullar, Dinesh, Langkilde, Anna Maria, Wheeler, David C., Heerspink, Hiddo J. L., Chertow, Glenn M., Yu, Margaret K., Vart, Priya, Jongs, Niels, Correa-Rotter, Ricardo, Rossing, Peter, McMurray, John J. V., Hou, Fan-Fan, Douthat, Walter, Khullar, Dinesh, Langkilde, Anna Maria, Wheeler, David C., Heerspink, Hiddo J. L., and Chertow, Glenn M.

Abstract

BACKGROUND: The sodium-glucose cotransporter type 2 inhibitor dapagliflozin reduces the risk of progressive kidney disease and cardiovascular events in patients with chronic kidney disease, with and without type 2 diabetes. Whether its effects are uniform across the spectrum of age and among men and women is unknown.OBJECTIVE: We performed a pre-specified analysis in DAPA-CKD to evaluate efficacy and safety of dapagliflozin according to baseline age and sex.DESIGN: Prospective randomized placebo-controlled trial.PARTICIPANTS: A total of 4304 adults with chronic kidney disease (estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73 m 2; urinary albumin-to-creatinine ratio 200-5000 mg/g) with and without type 2 diabetes. INTERVENTION: Dapagliflozin 10 mg versus placebo once daily.MAIN MEASURES: Primary endpoint was a composite of ≥ 50% sustained eGFR decline, end-stage kidney disease, and kidney or cardiovascular death. Secondary endpoints included kidney composite endpoint (same as primary composite endpoint but without cardiovascular death), cardiovascular composite endpoint (hospitalized heart failure or cardiovascular death), and all-cause mortality.KEY RESULTS: Median follow-up was 2.4 years. Absolute risks of cardiovascular composite endpoint and all-cause mortality were higher in older patients. Absolute risk of kidney composite endpoint was highest in patients < 50 years (10.7 and 6.2 per 100 patient-years in the placebo and dapagliflozin groups, respectively) and lowest in patients ≥ 80 years (3.0 and 1.2 per 100 patient-years in the placebo and dapagliflozin groups, respectively). There was no evidence of heterogeneity of the effects of dapagliflozin on the primary or secondary endpoints based on age or sex. Neither age nor sex modified the effects of dapagliflozin on total or chronic eGFR slope.CONCLUSIONS: Dapagliflozin reduced the risks of mortality, cardiovascular events, and CKD progression i

Published
2024

40. Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty

Author

Vart, Priya, Butt, Jawad H, Jongs, Niels, Schechter, Meir, Chertow, Glenn M, Wheeler, David C, Pecoits-Filho, Roberto, Langkilde, Anna Maria, Correa-Rotter, Ricardo, Rossing, Peter, McMurray, John J V, Heerspink, Hiddo J L, Vart, Priya, Butt, Jawad H, Jongs, Niels, Schechter, Meir, Chertow, Glenn M, Wheeler, David C, Pecoits-Filho, Roberto, Langkilde, Anna Maria, Correa-Rotter, Ricardo, Rossing, Peter, McMurray, John J V, and Heerspink, Hiddo J L

Abstract

Background: A sizeable proportion of patients with chronic kidney disease (CKD) are reported to be frail. Here we examined the safety andefficacy of dapagliflozin in patients with CKD by frailty level.Methods: Adults with CKD, with/without type 2 diabetes, with an estimated glomerular filtration rate (eGFR) of 25–75 mL/min/1.73 m2 , andurinary albumin-to-creatinine ratio 200–5 000 mg/g were randomized to dapagliflozin (10 mg/day) or placebo. The primary endpoint was a com-posite of sustained ≥50% eGFR decline, end-stage kidney disease (ESKD), or death from kidney or cardiovascular (CV) causes.Results: Frailty index (FI), assessed by Rockwood cumulative deficit approach, was calculable in 4 303/4 304 (99.9%) patients: 1 162 (27.0%)in not-to-mildly frail (FI ≤0.210), 1 642 (38.2%) in moderately frail (FI 0.211–0.310), and 1 499 (34.8%) in severely frail categories (FI >0.311).Dapagliflozin reduced the risk of the primary composite endpoint across all FI categories (hazard ratios [95% confidence interval {CI}]: 0.50[0.33–0.76], 0.62 [0.45–0.85], and 0.64 [0.49–-0.83], respectively; p-interaction = 0.67). Results were similar for secondary outcomes includ-ing kidney composite outcome (sustained ≥50% eGFR decline, ESKD or death from kidney cause; p-interaction = 0.44), CV endpoint (heartfailure hospitalization or CV death; p-interaction = 0.63), and all-cause mortality (p-interaction p = .42). Results were consistent when usingFI as a continuous variable. Occurrence of serious adverse events was numerically lower in patients receiving dapagliflozin versus placeboin all FI categories (16.9% vs 20.1%, 26.3% vs 30.7%, and 42.9% vs 47.8%, in not-to-mildly, moderately, and severely frail categories,respectively).Conclusions: The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associatedsafety., BACKGROUND: A sizeable proportion of patients with chronic kidney disease (CKD) are reported to be frail. Here we examined the safety and efficacy of dapagliflozin in patients with CKD by frailty level.METHODS: Adults with CKD, with/without type 2 diabetes, with estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73m 2 and urinary albumin-to-creatinine ratio 200-5000 mg/g were randomized to dapagliflozin (10 mg/day) or placebo. The primary endpoint was composite of sustained ≥50% eGFR decline, end-stage kidney disease (ESKD) or death from kidney or cardiovascular (CV) causes.RESULTS: Frailty index (FI), assessed by Rockwood cumulative deficit approach, was calculable in 4303/4304 (99.9%) patients: 1162 (27.0%) in not-to-mildly frail(FI≤0.210), 1642 (38.2%) in moderately frail(FI 0.211-0.310), and 1499 (34.8%) in severely frail categories (FI>0.311). Dapagliflozin reduced the risk of the primary composite endpoint across all FI categories (hazard ratios [95% CI]: 0.50 [0.33-0.76], 0.62 [0.45-0.85], and 0.64 [0.49-0.83], respectively (P-interaction =0.67). Results were similar for secondary outcomes including kidney composite outcome (sustained ≥50% eGFR decline, ESKD or death from kidney cause; P-interaction=0.44), CV endpoint (heart failure hospitalization or CV death; P-interaction=0.63), and all-cause mortality (P-interaction p=0.42). Results were consistent when using FI as a continuous variable. Occurrence of serious adverse events was numerically lower in patients receiving dapagliflozin vs. placebo in all FI categories (16.9% vs. 20.1%, 26.3% vs. 30.7%, and 42.9% vs 47.8%, in not-to-mildly, moderately and severely frail categories, respectively).CONCLUSIONS: The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associated safety.

Published
2024

41. Achieved dose and treatment discontinuation of candesartan in men and women with chronic heart failure: data from CHARM.

Author

Qin, Hailun, Dewan, Pooja, Santema, Bernadet T., ter Maaten, Jozine M., Swedberg, Karl, McMurray, John J. V., and Voors, Adriaan A.

Subjects
ANGIOTENSIN-receptor blockers, HEART failure, VENTRICULAR ejection fraction, TERMINATION of treatment, CLINICAL trials
Abstract

Aims: Angiotensin receptor blockers have been shown to reduce heart failure hospitalization and cardiovascular mortality in men and women with heart failure with reduced ejection fraction (HFrEF). It is unknown whether there are differences between men and women in achieved dose and treatment discontinuation due to adverse events of candesartan. Methods and results: We conducted a post hoc analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme. A total of 3172 men and 1106 women with HFrEF [left ventricular ejection fraction (LVEF) ≤ 40%] in New York Heart Association class II–IV were randomized to candesartan or placebo. Every 2 weeks, patients were up‐titrated from 4 or 8, to16, to 32 mg once daily, unless a higher dose was contraindicated or not tolerated. Women were older (66 vs. 64 years), had a higher LVEF (29.9% vs. 28.6%), and had more hypertension (54% vs. 47%) than men. The mean achieved dose of candesartan was 21.5 ± 12.6 mg in men and 20.7 ± 12.9 mg in women (P = 0.19). In both the candesartan and placebo groups, cardiovascular death and heart failure hospitalizations were higher in men and women who achieved lower dose levels. Event rates for achieved dose levels of 0, 4 or 8, 16, and 32 mg candesartan were 20.8, 17.2, 14.0, and 10.1 per 100 person‐years in men, respectively, and 23.6, 13.7, 14.0, and 9.1 per 100 person‐years in women, respectively. In each of the achieved dose levels, there was no sex difference in the proportion of patients with an event, neither in the candesartan group nor in the placebo group (P‐value for all > 0.05). There was no significant interaction between sex and treatment‐related discontinuation for hypotension (P = 0.520), an increase in creatinine (P = 0.102), and hyperkalaemia (P = 0.905). Conclusions: In a randomized clinical trial in patients with HFrEF, men and women achieved similar doses of candesartan. Primary event rates and treatment‐related discontinuation due to adverse events were also similar between men and women. [ABSTRACT FROM AUTHOR]

Published
2024
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42. Safety and Tolerability of Angiotensin Receptor-Neprilysin Inhibitor Initiation in High-Risk Acute Myocardial Infarction Relative to Care Setting: A Subgroup Analysis of the PARADISE-MI Trial.

Author

De Pasquale, Carmine G., Claggett, Brian, Jering, Karola, McMurray, John J. V., Mann, Douglas, Miao, Zi Michael, Granger, Christopher B., Køber, Lars, Maggioni, Aldo P., Rouleau, Jean-Lucien, Solomon, Scott D., Steg, Philippe Gabriel, van der Meer, Peter, Braunwald, Eugene, and Pfeffer, Marc A.

Published
2024
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43. Trends in cardiovascular disease incidence among 22 million people in the UK over 20 years: population based study.

Author

Conrad, Nathalie, Molenberghs, Geert, Verbeke, Geert, Zaccardi, Francesco, Lawson, Claire, Friday, Jocelyn M., Su, Huimin, Jhund, Pardeep S., Sattar, Naveed, Rahimi, Kazem, Cleland, John G., Khunti, Kamlesh, Budts, Werner, and McMurray, John J. V.

Subjects
AORTIC aneurysms, CARDIOVASCULAR diseases, RESEARCH funding, MYOCARDIAL ischemia, SEX distribution, PERIPHERAL vascular diseases, VEINS, AGE distribution, POPULATION geography, HEART failure, DESCRIPTIVE statistics, ACUTE coronary syndrome, CHRONIC diseases, ODDS ratio, AORTIC stenosis, ATRIAL fibrillation, THROMBOEMBOLISM, ATRIAL flutter, HEART block, STROKE, CONFIDENCE intervals, SOCIAL classes, DISEASE incidence, REGRESSION analysis
Published
2024
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44. Revisiting Race and the Benefit of RAS Blockade in Heart Failure: A Meta-Analysis of Randomized Clinical Trials.

Author

Shen, Li, Lee, Matthew M. Y., Jhund, Pardeep S., Granger, Christopher B., Anand, Inder S., Maggioni, Aldo P., Pfeffer, Marc A., Solomon, Scott D., Swedberg, Karl, Yusuf, Salim, and McMurray, John J. V.

Subjects
CLINICAL trials, RACE, HEART failure, BLACK people, ANGIOTENSIN-receptor blockers
Abstract

Key Points: Question: Does the benefit of renin-angiotensin system (RAS) blockers in patients with heart failure and reduced ejection fraction differ between Black and non-Black patients? Findings: In this meta-analysis involving more than 16 000 patients from 5 randomized trials, the mortality benefit from RAS blockade was similar in Black and non-Black patients. Although the relative risk reduction in hospitalizations for heart failure was smaller in Black patients, the absolute benefit was comparable in the 2 groups given the greater incidence of hospitalization in Black patients. Meaning: RAS blockers are effective at improving cardiovascular outcomes in Black and non-Black patients with heart failure. Importance: Concerns have arisen that renin-angiotensin system (RAS) blockers are less effective in Black patients than non-Black patients with heart failure and reduced ejection fraction (HFrEF). Objective: To determine whether the effects of RAS blockers on cardiovascular outcomes differ between Black patients and non-Black patients with HFrEF. Data Sources: MEDLINE and Embase databases through December 31, 2023. Study Selection: Randomized trials investigating the effect of RAS blockers on cardiovascular outcomes in adults with HFrEF that enrolled Black and non-Black patients. Data Extraction and Synthesis: Individual-participant data were extracted following Preferred Reporting Items for Systematic Reviews and Meta-analyses Independent Personal Data (PRISMA-IPD) reporting guidelines. Effects were estimated using a mixed-effects model using a 1-stage approach. Main Outcome and Measure: The primary outcome was first hospitalization for HF or cardiovascular death. Results: The primary analysis, based on the 3 placebo-controlled RAS inhibitor monotherapy trials, included 8825 patients (9.9% Black). Rates of death and hospitalization for HF were substantially higher in Black than non-Black patients. The hazard ratio (HR) for RAS blockade vs placebo for the primary composite was 0.84 (95% CI, 0.69-1.03) in Black patients and 0.73 (95% CI, 0.67-0.79) in non-Black patients (P for interaction =.14). The HR for first HF hospitalization was 0.89 (95% CI, 0.70-1.13) in Black patients and 0.62 (95% CI, 0.56-0.69) in non-Black patients (P for interaction =.006). Conversely, the corresponding HRs for cardiovascular death were 0.83 (95% CI, 0.65-1.07) and 0.84 (95% CI, 0.77-0.93), respectively (P for interaction =.99). For total hospitalizations for HF and cardiovascular deaths, the corresponding rate ratios were 0.82 (95% CI, 0.66-1.02) and 0.72 (95% CI, 0.66-0.80), respectively (P for interaction =.27). The supportive analyses including the 2 trials adding an angiotensin receptor blocker to background angiotensin-converting enzyme inhibitor treatment (n = 16 383) gave consistent findings. Conclusions and Relevance: The mortality benefit from RAS blockade was similar in Black and non-Black patients. Despite the smaller relative risk reduction in hospitalization for HF with RAS blockade in Black patients, the absolute benefit in Black patients was comparable with non-Black patients because of the greater incidence of this outcome in Black patients. This meta-analysis assesses whether Black patients with heart failure and reduced ejection fraction respond differently than patients of other races to renin-angiotensin system (RAS) blockade by examining individual patient data from randomized clinical trials. [ABSTRACT FROM AUTHOR]

Published
2024
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45. Sodium-Glucose Cotransporter-2 Inhibitors and Major Adverse Cardiovascular Outcomes: A SMART-C Collaborative Meta-Analysis.

Author

Patel, Siddharth M., Yu Mi Kang, KyungAh Im, Neuen, Brendon L., Anker, Stefan D., Bhatt, Deepak L., Butler, Javed, Cherney, David Z. I., Claggett, Brian L., Fletcher, Robert A., Herrington, William G., Inzucchi, Silvio E., Jardine, Meg J., Mahaffey, Kenneth W., McGuire, Darren K., McMurray, John J. V., Neal, Bruce, Packer, Milton, Perkovic, Vlado, and Solomon, Scott D.

Published
2024
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46. Effect of albiglutide on cardiovascular outcomes in older adults: A post hoc analysis of a randomized controlled trial

Author

Gilbert, Matthew P., primary, Skelly, Joan, additional, Hernandez, Adrian F., additional, Green, Jennifer B., additional, Krychtiuk, Konstantin A., additional, Granger, Christopher B., additional, Leiter, Lawrence A., additional, McMurray, John J. V., additional, Del Prato, Stefano, additional, and Pratley, Richard E., additional

Published
2024
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48. Effects of albiglutide on myocardial infarction and ischaemic heart disease outcomes in patients with type 2 diabetes and cardiovascular disease in the Harmony Outcomes trial

Author

Krychtiuk, Konstantin A, primary, Marquis-Gravel, Guillaume, additional, Murphy, Shannon, additional, Alexander, Karen P, additional, Chiswell, Karen, additional, Green, Jennifer B, additional, Leiter, Lawrence A, additional, Lopes, Renato D, additional, Del Prato, Stefano, additional, Jones, William Schuyler, additional, McMurray, John J V, additional, Hernandez, Adrian F, additional, and Granger, Christopher B, additional

Published
2024
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49. Dapagliflozin and Mode of Death in Heart Failure With Improved Ejection Fraction

Author

Vardeny, Orly, primary, Desai, Akshay S., additional, Jhund, Pardeep S., additional, Fang, James C., additional, Claggett, Brian, additional, de Boer, Rudolf A., additional, Hernandez, Adrian F., additional, Inzucchi, Silvio E., additional, Kosiborod, Mikhail N., additional, Lam, Carolyn S. P., additional, Martinez, Felipe A., additional, Shah, Sanjiv J., additional, Mc Causland, Finnian R., additional, Petrie, Mark C., additional, Vaduganathan, Muthiah, additional, McMurray, John J. V., additional, and Solomon, Scott D., additional

Published
2024
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