💥My top 10 learning points from the #ESCCongress 2021💥
A thread for cardiologists/general physicians
1) There is a treatment for HFpEF!
Empagliflozin significantly ⬇️composite of HF hospitalisation & CV death by 21%
Evidence: EMPEROR-Preserved nejm.org/doi/full/10.10…
1/n
2) A more aggressive BP target (110 to 130 Vs 130 to 150) in elderly patients resulted in lower rates of cardiovascular events
Evidence: STEP study -nejm.org/doi/full/10.10…
2/n #ESCCongress
3) Using a salt substitute ⬇️risk of stroke, major CV events and total mortality.
Evidence: SSaSS study - nejm.org/doi/full/10.10…
3/n #ESCCongress
4) Patients with OOHCA & ROSC without STE or LBBB on ECG have no benefit of immediate angiography Vs initial intensive care evaluation with delayed angiography if indicated
Evidence: TOMAHAWK - nejm.org/doi/full/10.10…
4/n #ESCCongress
5) Dapagliflozin decreases risk of serious ventricular arrhythmia, cardiac arrest or sudden death when added to conventional therapy in pts with HFrEF by 21%
Evidence: Post hoc analysis of DAPA HF - academic.oup.com/eurheartj/adva…
5/n #ESCCongress
6) Influenza vaccine given early after an MI or high-risk coronary disease results in a lower risk of all-cause death/MI/stent thrombosis
Evidence: IAMI - ahajournals.org/doi/10.1161/CI…
6/n #ESCCongress
7)Giving high risk COVID pts treatment dose LMWH has a NNT of 8 to prevent one major thromboembolic event and death
Evidence: HEP-COVID trial (not yet published; clinicaltrials.gov/ct2/show/NCT04…)
7/n #ESCCongress
8) Putting an ILR into pts will find more AF (threefold increase in detection) but even with anticoagulation current evidence does NOT show this to decrease stroke (?due to short duration of AF)
Evidence: LOOP study - thelancet.com/journals/lance…
8/n #ESCCongress
9) In pts discharged after at least 3d hospitalisation with COVID,use of rivaroxaban 10mg OD for 35d in those with ⬆️IMPROVE score resulted in better clinical outcomes without increased bleeding
Evidence:MICHELLE trial,not yet published acc.org/latest-in-card…
9/n #ESCCongress
10) Exercise improves freedom from AF and decreases AF symptom severity
Evidence: ACTIVE AF (not yet published; escardio.org/The-ESC/Press-…)
10/10 #ESCCongress
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