2022 PRACTICE-CHANGING CLINICAL TRIALS #recap
~~ a thread 🧵 ~~ 👇
1/ SGLT2 inhibition initiation in the acute hospital setting? This trial showed significant benefit — REGARDLESS of ejection fraction — safe, and with incrementally added benefit when started early. EMPULSE Trial, Nature Medicine, 2022 ♥️
2/ SGLT2 inhibition for HFpEF? This trial showed SGLT2 inhibitors to have mortality benefit with EF > 40%, regardless of diabetes status. HFpEF represents a population of patients that beyond diuretic use, has historically been difficult to treat. DELIVER Trial, NEJM 2022 ♥️
3/ Use of carbonic anhydrase inhibitors in HF? Acetazolamide blocks reabsorption of sodium bicarb in the kidney, leading to ⬆️ natriuresis. This landmark trial showed faster achievement of euvolemia with acetazolamide routinely added. ADVOR Trial, NEJM 2022 ♥️
4/ Jumping straight to the cath lab for patients with stable chest pain? Perhaps not ☝️. More and more evidence supports CT coronary angiography in supplanting invasive strategies in the initial diagnosis and management of CAD. DISCHARGE Trial, NEJM 2022 ♥️
#yesCCT #ccta @leilii
5/ Myosin inhibitors for HCM? Negative inotropes are the standard of care for obstructive HCM. If medical therapy fails, surgical myomectomy can relieve symptoms. This trial showed mavacamten (inhibits actin-myosin binding)to reduce need for surgery. VALOR-HCM Trial, NEJM 2022 ♥️
6/ Degree of blood pressure control in pregnancy? This key trial showed strict BP control (<140/90) to improve fetal outcomes over lenient control (<160/105). A message to all us providers treating pregnant patients. CHAP Trial, NEJM 2022 ♥️
#cardioOb #womenshealth
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