Avsnitt
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In this episode of JACC podcast, Dr. Valentin Fuster highlights key studies from the February 4th, 2025 issue, including the rising prevalence and mortality of coagulase-negative staphylococcal endocarditis and the clinical implications of new diagnostic technologies like photon-counting detector CT for coronary artery disease. Other highlights include discussions on P2Y12 inhibitor pretreatment in acute coronary syndrome, cardiologist integration into hospital systems, and reviews on heart failure medication costs and myocarditis management strategies.
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In this podcast, Dr. Valentin Fuster discusses a study on Coagulase-negative Staphylococcal Endocarditis (CoNS), a growing concern in the healthcare setting, particularly among the elderly and those with comorbidities. The study's findings on high mortality rates, surgical interventions, and the promising future role of artificial intelligence in diagnosing and predicting the disease are highlighted, offering new perspectives on this complex and life-threatening condition.
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Saknas det avsnitt?
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In this podcast, Dr. Valentin Fuster discusses a study on the use of P2Y12 inhibitor pretreatment in patients with non-ST elevation acute coronary syndrome, revealing significant variability in its application across institutions and operators. Despite initial hypotheses of benefit, the findings indicate no significant difference in patient outcomes, suggesting that routine pretreatment may not be necessary, especially when treatment is initiated within 24 hours of symptom onset.
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In this podcast, Dr. Valentin Fuster discusses a groundbreaking study comparing photon counting detector (PCD) CT technology with traditional EIDCT for diagnosing coronary artery disease. The research suggests that PCDCT offers superior specificity and diagnostic accuracy, potentially replacing older methods, and could revolutionize cardiac imaging by reducing the need for invasive procedures and improving patient outcomes.
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In this podcast, Dr. Valentin Fuster discusses a study comparing patient outcomes and care quality between cardiologists who transitioned from independent practice to hospital employment and those who remained independent. Despite a significant rise in hospital-employed cardiologists, the study reveals minimal differences in patient outcomes and care quality, challenging the assumption that hospital employment leads to better healthcare results.
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In this podcast, Dr. Valentin Fuster explores the 2024 ACC Expert Consensus on myocarditis, highlighting critical advancements in the understanding, diagnosis, and treatment of this condition. Key takeaways include the introduction of a new four-stage classification, updated diagnostic criteria, and the emphasis on timely referrals, while also addressing the importance of genetic counseling, ongoing patient follow-up, and the need for further research in this evolving field.
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In this podcast, Dr. Valentin Fuster discusses the growing issue of high out-of-pocket costs for heart failure medications and highlights potential solutions. The review covers a range of cost-saving strategies, such as prescription discount cards and patient assistance programs, and also explores policy changes, like those introduced by the Inflation Reduction Act, that aim to reduce medication costs for Medicare beneficiaries starting in 2025.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.
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Podcast Overview
The podcast, hosted by Valentin Fuster on January 21, 2025, provides an in-depth review of the FINEARTS-HF trial, which evaluated the efficacy of the non-steroidal mineralocorticoid receptor antagonist finerenone in patients with heart failure and mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). The episode highlights findings published in the Journal of the American College of Cardiology (JACC).
Introduction to the FINEARTS-HF Trial (00:03:19 – 00:05:56)
The FINEARTS-HF trial demonstrated that finerenone reduced heart failure events by 16% compared to placebo in patients with HFmrEF/HFpEF. However, cardiovascular death rates were similar between groups, making the overall clinical impact moderate.Finerenone’s Impact on Quality of Life (00:05:59 – 00:12:46)
The trial assessed quality of life using the Kansas City Cardiomyopathy Questionnaire (KCCQ), revealing only a slight improvement (1.62 points) with finerenone. Critics, including the FDA, questioned the clinical relevance of these results and suggested the need for simpler, more meaningful patient-reported outcome measures.Finerenone in Patients with Recent Worsening Heart Failure (00:12:58 – 00:20:30)
Patients with recent worsening heart failure showed a greater absolute benefit from finerenone, as they were at higher risk of recurrent events and cardiovascular death. However, further studies are needed to confirm these findings.Finerenone’s Role in Obese Patients with HFmrEF/HFpEF (00:20:31 – 00:25:20)
In obese patients, the benefits of finerenone were consistent across body mass index (BMI) categories, with a possible greater effect in those with higher BMI. Nevertheless, the reliance on BMI as a metric for obesity was criticized, and alternative measures were recommended.Finerenone and Kidney Outcomes (00:25:23 – 00:40:52)
Finerenone showed a modest reduction in albuminuria but did not significantly alter kidney disease progression. Initial declines in glomerular filtration rate (GFR) were noted but should not automatically lead to discontinuation of therapy. Mixed findings highlight the need for more research to understand its renal effects.Conclusion (00:40:54 – 00:44:05)
The FINEARTS-HF trial was recognized as a landmark study, showcasing modest benefits of finerenone in a challenging patient population. The podcast calls for continued research to refine quality of life metrics, better understand obesity’s role in HFmrEF/HFpEF, and explore finerenone’s long-term renal and cardiovascular impacts. -
Podcast Overview
The podcast, hosted by Valentin Fuster on January 21, 2025, provides an in-depth review of the FINEARTS-HF trial, which evaluated the efficacy of the non-steroidal mineralocorticoid receptor antagonist finerenone in patients with heart failure and mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). The episode highlights findings published in the Journal of the American College of Cardiology (JACC).
Introduction to the FINEARTS-HF Trial (00:03:19 – 00:05:56)
The FINEARTS-HF trial demonstrated that finerenone reduced heart failure events by 16% compared to placebo in patients with HFmrEF/HFpEF. However, cardiovascular death rates were similar between groups, making the overall clinical impact moderate.Finerenone’s Impact on Quality of Life (00:05:59 – 00:12:46)
The trial assessed quality of life using the Kansas City Cardiomyopathy Questionnaire (KCCQ), revealing only a slight improvement (1.62 points) with finerenone. Critics, including the FDA, questioned the clinical relevance of these results and suggested the need for simpler, more meaningful patient-reported outcome measures.Finerenone in Patients with Recent Worsening Heart Failure (00:12:58 – 00:20:30)
Patients with recent worsening heart failure showed a greater absolute benefit from finerenone, as they were at higher risk of recurrent events and cardiovascular death. However, further studies are needed to confirm these findings.Finerenone’s Role in Obese Patients with HFmrEF/HFpEF (00:20:31 – 00:25:20)
In obese patients, the benefits of finerenone were consistent across body mass index (BMI) categories, with a possible greater effect in those with higher BMI. Nevertheless, the reliance on BMI as a metric for obesity was criticized, and alternative measures were recommended.Finerenone and Kidney Outcomes (00:25:23 – 00:40:52)
Finerenone showed a modest reduction in albuminuria but did not significantly alter kidney disease progression. Initial declines in glomerular filtration rate (GFR) were noted but should not automatically lead to discontinuation of therapy. Mixed findings highlight the need for more research to understand its renal effects.Conclusion (00:40:54 – 00:44:05)
The FINEARTS-HF trial was recognized as a landmark study, showcasing modest benefits of finerenone in a challenging patient population. The podcast calls for continued research to refine quality of life metrics, better understand obesity’s role in HFmrEF/HFpEF, and explore finerenone’s long-term renal and cardiovascular impacts. -
Podcast Overview
The podcast, hosted by Valentin Fuster on January 21, 2025, provides an in-depth review of the FINEARTS-HF trial, which evaluated the efficacy of the non-steroidal mineralocorticoid receptor antagonist finerenone in patients with heart failure and mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). The episode highlights findings published in the Journal of the American College of Cardiology (JACC).
Introduction to the FINEARTS-HF Trial (00:03:19 – 00:05:56)
The FINEARTS-HF trial demonstrated that finerenone reduced heart failure events by 16% compared to placebo in patients with HFmrEF/HFpEF. However, cardiovascular death rates were similar between groups, making the overall clinical impact moderate.Finerenone’s Impact on Quality of Life (00:05:59 – 00:12:46)
The trial assessed quality of life using the Kansas City Cardiomyopathy Questionnaire (KCCQ), revealing only a slight improvement (1.62 points) with finerenone. Critics, including the FDA, questioned the clinical relevance of these results and suggested the need for simpler, more meaningful patient-reported outcome measures.Finerenone in Patients with Recent Worsening Heart Failure (00:12:58 – 00:20:30)
Patients with recent worsening heart failure showed a greater absolute benefit from finerenone, as they were at higher risk of recurrent events and cardiovascular death. However, further studies are needed to confirm these findings.Finerenone’s Role in Obese Patients with HFmrEF/HFpEF (00:20:31 – 00:25:20)
In obese patients, the benefits of finerenone were consistent across body mass index (BMI) categories, with a possible greater effect in those with higher BMI. Nevertheless, the reliance on BMI as a metric for obesity was criticized, and alternative measures were recommended.Finerenone and Kidney Outcomes (00:25:23 – 00:40:52)
Finerenone showed a modest reduction in albuminuria but did not significantly alter kidney disease progression. Initial declines in glomerular filtration rate (GFR) were noted but should not automatically lead to discontinuation of therapy. Mixed findings highlight the need for more research to understand its renal effects.Conclusion (00:40:54 – 00:44:05)
The FINEARTS-HF trial was recognized as a landmark study, showcasing modest benefits of finerenone in a challenging patient population. The podcast calls for continued research to refine quality of life metrics, better understand obesity’s role in HFmrEF/HFpEF, and explore finerenone’s long-term renal and cardiovascular impacts. - Visa fler
