1)
... more from the #ESCCongress2021 from the @GoggleDocs #Takeover of the @cardiomet_CE

Next up the EMPEROR-Pooled analysis and some of the questions it asks

How does empagliflozin compare with ARNI (sacubitral/valsartan
2)
EMPEROR-Pooled was a prespecified analysis of the two 'sister' studies

EMPEROR-Reduced Trial
nejm.org/doi/full/10.10…

and

EMPEROR-Preserved Trial
nejm.org/doi/full/10.10…

With very similar #HeartFailure populations, separated by an ejection fraction cut off of 40%
3)

As you can see

📍Very similar results in terms of the primary and secondary #HeartFailure outcomes.

‼️ Although clear attenuation of benefit seen in pople with higher ejection fractions (EF)
4)

‼️Benefits in terms of the risk of hospitalisation for heart failure appear to be consistent below an EF of 65%

⚠️Currently this drug is only licensed if EF <40%

🤞This will change soon, as many people with #HeartFailure have an EF 40-65% (elderly & #type2diabetes)
5)
How does this attenuation of benefits compare in other #HeartFailure studies?

🥇 empagliflozin benefits people if EF<65%

🥈sacubitril/valsartan may benefit if <EF62.5%

🥉spironolactone may benefit if EF<60%
6)

How does this compare to ARNI (sacubitril/valsartan)?

Milton Packer gives us his thoughts

⚠️No direct comparison undertaken

✅empagliflozin appears to have a greater magnitude of benefit than sacubitril/valsartan at all EF categories
7)

What about the #kidney benefits?

⚠️Both studies were not renal outcome studies

‼️Composite renal outcomes differ between studies.

‼️ Using a different composite we can see similar attenuation of benefits of empagliflozin on Kidney outcomes as we see with #HeartFailure
9) In Conclusion

empagliflozin 10mg in people with #HeartFailure

1) ⤵️🏥💔+CV☠️ in both "HFrEF" & "HFpEF"

2) outcomes driven by ⤵️🏥💔

3) No benefits seen if EF>65

4) Kidney benefits may be similarly attenuated at higher EF

• • •

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More from @cardiomet_CE

10 Sep
STEP this way for the last of our tweetorials covering #ESCCongress @escardio Looking at a trial of intensive blood pressure control in older adults with hypertension
First...step aside to a different STEP trial – Semaglutide in Obesity – our last tweetorial on this was very popular – have a look!
Now step forward to this tweetorial on BP lowering…
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9 Sep
Welcome to the final set of tweetorials from @GoggleDocs A look at some of the interesting trials on hypertension from #ESCCongress
First up we're giving you some SSaSS!
No, not that, we are talking about salt and salt substitution!
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8 Sep
The @GoggleDocs takeover of @cardiomet_CE continues!

We are 4 UK 🇬🇧 based doctors working across healthcare

Our interests are "what's new, and meaningful in cardiorenal metabolic medicine"

Check out our YouTube channel youtube.com/c/GoggleDocs Image
Yesterday we had key messages from the seminal EMPEROR-Preserved trial✅ & EMPEROR-Pooled analysis✅ presented at the #ESCCongress2021

Today we have key messages from the FIGARO-DKD study & FIDELITY meta-analysis exploring the use of finerenone in T2D & a wide range of CKD Image
Let's start with some background - for starters what in the earth is finerenone?!
Read 26 tweets
7 Sep
1) Welcome to a new joint-accredited #tweetorial on the highlights of cutting-edge #cardiometabolic research from this years #ESCCongress. We are
@GoggleDocs. Follow this tweetorial to earn FREE 0.75h credit, #physicians #nurses #pharmacists!
@MedTweetorials
#FOAMed #medtwitter
2) This program is intended for healthcare professionals and is supported by educational grants from AstraZeneca, Bayer, Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company, Chiesi, and NovoNordisk. See archived programs at cardiometabolic-ce.com.
3) Over the next 3 days the @GoggleDocs will be #Takeover with @cardiomet_CE account.

We are four 🇬🇧 based doc working across healthcare.

Our interests are "what's new, and meaning full in cardio-renal metabolic medicine"

Check out our YouTube channel youtube.com/c/GoggleDocs
Read 16 tweets
16 Aug
We are the only home for CE/#CME tweetorials in the #cardiometabolic space, but realize our faculty and their colleagues also deliver the highest-quality "traditional" accredited education. Please use and share these resources for FREE accredited education:
Journal supplement: The Diminishing Role of Aspirin in the Management of Cardiovascular Disease, view at ajconline.org/issue/S0002-91… and then claim up to 8h credit at academiccme.com/AJC-Supplement/
Webcast: Clinical Updates for the Management of Patients with Pulmonary Arterial Hypertension, view and claim 0.75h credit at academiccme.com/courses/clinic…
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30 Jul
Don't miss the launch Monday of a new accredited tweetorial on optimizing duration of antiplatelet therapy after #ACS/#PCI, with expert author @mirvatalasnag leading us through the data. #ACCWIC @DrMarthaGulati @ShelleyZieroth @TYWangMD @Drroxmehran @aayshacader #cardiotwitter Image
Watch here tomorrow a new accredited, serialized tweetorial on optimizing duration of antiplatelet therapy after ACS/PCI. Earn 0.5 CE/#CME credits: #physicians, #nurses, #pharmacists! Expert faculty @mirvatalasnag. #medtwitter @academiccme #cardiotwitter #FOAMed @CardioNerds
1) Welcome to a tweetorial on optimizing duration of antiplatelet tx after #ACS/#PCI! Accredited for 0.50 credits by @academiccme! I am @mirvatalasnag . Be sure to see prior tweetorials on this topic and still earn credit at cardiometabolic-ce.com/category/plate… Image
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