Everyone excited about MEDICATIONS but lifestyle receives little attention. Some MDs say it's too hard to convince patients. It sometimes is then again they just may SUCK AT IT.

This were slides I made back from DAPAHF in ESCCONGRESS

👀 #HeartFailure2023 #LBCT Announced

This will be THE🌎meeting for the latest in HF!

🔥 #PARAGLIDE + #PARAGON : a final word on #ARNI in #HF pEF
🔥 #FINEARTS : baseline data from largest #MRA RCT in #HF pEF
🔥 #DELIVER + #DAPAHF : #PAD #WinRatio #KCCQ
🔥 #NUDGEFLU : vaccination in #HF

After #GALACTICHF #VICTORIA #EMPEROR and #DAPAHF a much needed 'quick 'n dirty' graph on the 1 Year Mortality risk and 2 year CV Death/HF Hosp risk in relation to #ARR and #NNT in contemporary #HFREF treatment. You decide what will be the new gold standard! #heartfailure #AHA20

DAPA-HF: en pacientes con IC con FEr, Dapagliflozina 10mg ⬇️26% el enpoint 1º combinado(NNT:21), ⬇️30% episodio de descompensacion y ⬇️18% muerte CV ... SIN DIFERENCIAS ENTRE DIABÉTICOS y NO DM. Dapa loves ♥️. #ESCCongress #dapahf

DAPA-HF; consistent effect in patients with and without diabetes with a reduction in heart failure events. #AHA19 #dapahf

Who has goosebumps?

SGLT2i ⬇️ HHF/CVD in pts w/ HFrEF both w/ and w/o T2DM!

Congratulations to the #DAPAHF investigators!

SGLT2 inhibitors for the win - impressive results from DAPAHF. But, how do we incorporate yet another medication into HF GDTM? 🤔

Regarding the #ESCCongress reaction on #DAPAHF I share the enthusiasm of most. For this very reason I made this thread which I hope will raise the curiosity of others.

It shows some shared pathways of medication and #Lifestyle that are obviously not mutually exclusive. (1/4)

#ESCCongress 2022 #LBCT Lineup Announced!

#DELIVER to be headlined in an entire Hotline Session with 3 main presentations on Sat Aug 27:

🔥 Main #DELIVER Results
🔥 #DELIVER + #DAPAHF Pooled across #LVEF
🔥 #DELIVER + #EMPERORPreserved Meta-Analysis

escardio.org/Congresses-&-E…

📍Dapagliflozin & the Incidence of T2 Diabetes in 👥w/
#HeartFailure & Reduced Ejection Fraction: An exploratory analysis of #DAPAHF
🔹2605👥 & no prior DM & HbA1c <6.5%
🔹Dapagliflozin ↘️ 32% in DM incidence (HR 0.68)
#CardioEd #CardioTwitter #HFrEF

20 min masterclass on the history of #SGLT2i RCTs, key diffs between #EMPEROR_REDUCED & #DAPAHF , how risk profile of patients may affect study outcomes, drug vs class effects & more w/ Dr Milton Packer🌟 #heartfailure #ESCCongress
radcliffecardiology.com/emperor-reduce…

nejm.org/doi/full/10.10…

📌 #Dapagliflozin reduces uric acid concentration, an independent predictor of adverse outcomes in #DAPAHF
#CardioEd   #CardioTwitter

📌Dapagliflozin & atrial fibrillation in #HeartFailure w/ ⬇️ EF: Insights from #DAPAHF
🔸Dapa ↘️ risk of HF events, ❤️death, and all-cause death, & ⬆️ symptoms, in 👥 with & without AF.
🔸Dapa did not ↘️ the risk of new-onset AF.
#CardioEd #CardioTwitter

#CCCongress #DAPAHF results presented
In HFrEF
💥No change in diuretic dose
💥Slows progression of deterioration of kidney function
💥Fall in BP with Dapa
💥Reduce risk of new DM
💥Significant reduction in CV death & HF hospitalization in those with w/ and w/o DM
💥On top of ARNI

Excited to present #KCCQ across the spectrum of EF from #DAPAHF & #DELIVER as a #LateBreaking trial update European Society of Cardiology #HFA2023 ! Many thanks to scottdavidsolomon Muthu Vaduganathan Mikhail Kosiborod & team for the opportunity! See everyone in Prague!

Rates of drug discontinuation similar to many chronic HFrEF trials, and importantly balanced btw SGLT2i & PBO arms. Discontinuation related to AE with an SGLT2i similar or ↓ vs. PBO.

↑ rates in #EMPERORReduced reflective of higher risk sample than #DAPAHF

#CONSORT diagrams 👇🏽

Congrats!

'Perceived intolerance', to the point of *not trying* #GDMTworks remains a core challenge.

Great data from #DAPAHF - Among the most frail, consistent relative benefits, larger absolute benefits w #SGLT2i . No excess risk of discontinuation/SAEs compared w placebo.

Effects of Dapagliflozin on #CV #Kidney & #Health Outcomes in HF

In each frame:
(L) #DAPAHF 'Heart Failure with Reduced Ejection Fraction'

(R) #DELIVER 'Heart Failure with Mildly Reduced or Preserved Ejection Fraction'

Remarkable consistency across the #LVEF spectrum. John Mandrola, MD

Dapagliflozina se consolida como farmaco obligado para el tratamiento de la insuficiencia cardíaca con disfunción sistolica independiente de que el paciente sea diabético #dapahf #ESCCongress

Recently diagnosed pts with HF are well-represented in RCTs!

#DAPAHF enrolled >1K pts w HF of just months duration. #DELIVER enrolled >600 pts in-hospital or within days of discharge

Longer HF duration = older & higher risk, but comparable benefit to Rx

ahajournals.org/doi/10.1161/CI…