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A year in heart failure : an update of recent findings
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Stretti, Lorenzo, Zippo, Dauphine, Coats, Andrew J. S., Anker, Markus S., von Haehling, Stephan, Metra, Marco and Tomasoni, Daniela (2021) A year in heart failure : an update of recent findings. ESC Heart Failure, 8 (6). pp. 4370-4393. doi:10.1002/ehf2.13760 ISSN 2055-5822.
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Official URL: https://doi.org/10.1002/ehf2.13760
Abstract
Major changes have occurred in these last years in heart failure (HF) management. Landmark trials and the 2021 European Society of Cardiology guidelines for the diagnosis and treatment of HF have established four classes of drugs for treatment of HF with reduced ejection fraction: angiotensin‐converting enzyme inhibitors or an angiotensin receptor‐neprilysin inhibitor, beta‐blockers, mineralocorticoid receptor antagonists, and sodium‐glucose co‐transporter 2 inhibitors, namely, dapagliflozin or empagliflozin. These drugs consistently showed benefits on mortality, HF hospitalizations, and quality of life. Correction of iron deficiency is indicated to improve symptoms and reduce HF hospitalizations. AFFIRM‐AHF showed 26% reduction in total HF hospitalizations with ferric carboxymaltose vs. placebo in patients hospitalized for acute HF (P = 0.013). The guanylate cyclase activator vericiguat and the myosin activator omecamtiv mecarbil improved outcomes in randomized placebo‐controlled trials, and vericiguat is now approved for clinical practice. Treatment of HF with preserved ejection fraction (HFpEF) was a major unmet clinical need until this year when the results of EMPEROR‐Preserved (EMPagliflozin outcomE tRial in Patients With chrOnic HFpEF) were issued. Compared with placebo, empagliflozin reduced by 21% (hazard ratio, 0.79; 95% confidence interval, 0.69 to 0.90; P < 0.001), the primary outcome of cardiovascular death or HF hospitalization. Advances in the treatment of specific phenotypes of HF, including atrial fibrillation, valvular heart disease, cardiomyopathies, cardiac amyloidosis, and cancer‐related HF, also occurred. Coronavirus disease 2019 (COVID‐19) pandemic still plays a major role in HF epidemiology and management. All these aspects are highlighted in this review.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Library of Congress Subject Headings (LCSH): | Heart failure, Heart failure -- Case studies, Heart failure -- Treatment, Heart failure -- Diagnosis | ||||||
Journal or Publication Title: | ESC Heart Failure | ||||||
Publisher: | John Wiley & Sons Ltd | ||||||
ISSN: | 2055-5822 | ||||||
Official Date: | 16 December 2021 | ||||||
Dates: |
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Volume: | 8 | ||||||
Number: | 6 | ||||||
Page Range: | pp. 4370-4393 | ||||||
DOI: | 10.1002/ehf2.13760 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 10 February 2022 | ||||||
Date of first compliant Open Access: | 11 February 2022 |
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