2024
Inpatient Use of Guideline-Directed Medical Therapy During Heart Failure Hospitalizations Among Community-Based Health Systems
Zheng J, Sandhu A, Bhatt A, Collins S, Flint K, Fonarow G, Fudim M, Greene S, Heidenreich P, Lala A, Testani J, Varshney A, Wi R, Ambrosy A. Inpatient Use of Guideline-Directed Medical Therapy During Heart Failure Hospitalizations Among Community-Based Health Systems. JACC Heart Failure 2024 PMID: 39269395, DOI: 10.1016/j.jchf.2024.08.004.Peer-Reviewed Original ResearchCommunity-based health systemQuality improvement registryHealth systemGuideline-directed medical therapyGuideline-directed medical therapy useEligible hospitalsImprovement registryNational quality improvement registryElectronic health record dataHealth record dataEvidence-based medicationsHF hospitalizationHeart failurePostdischarge strategiesHFrEF patientsFailure hospitalizationMedical therapyCommunity-basedAngiotensin receptor-neprilysin inhibitorSodium-glucose cotransporter 2 inhibitorsInpatient useRecord dataRenin-angiotensin system inhibitorsMineralocorticoid receptor antagonistsWorsening renal function
2023
Outcomes Associated with Sodium-Glucose Cotransporter-2 Inhibitor Use in Acute Heart Failure Hospitalizations Complicated by AKI
Aklilu A, Kumar S, Yamamoto Y, Moledina D, Sinha F, Testani J, Wilson F. Outcomes Associated with Sodium-Glucose Cotransporter-2 Inhibitor Use in Acute Heart Failure Hospitalizations Complicated by AKI. Kidney360 2023, 4: 1371-1381. PMID: 37644648, PMCID: PMC10615381, DOI: 10.34067/kid.0000000000000250.Peer-Reviewed Original ResearchConceptsAcute kidney injuryHeart failure hospitalizationSodium-glucose cotransporter-2 inhibitor useSodium-glucose cotransporter 2 inhibitorsAcute heart failure hospitalizationCotransporter 2 inhibitorsCox regression analysisRenal recoveryFailure hospitalizationAKI diagnosisKidney injuryInhibitor useLower riskStage 5 chronic kidney diseaseTime-varying Cox regression analysisKidney Disease Improving Global OutcomesInverse probability-weighted analysisMulticenter retrospective cohort studyMultivariable Cox regression analysisStage 5 CKDAcute heart failureRetrospective cohort studyChronic kidney diseaseKidney function recoveryGlomerular filtration rate
2022
Renal effects of guideline‐directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology
Mullens W, Martens P, Testani JM, Tang WHW, Skouri H, Verbrugge FH, Fudim M, Iacoviello M, Franke J, Flammer AJ, Palazzuoli A, Barragan PM, Thum T, Marcos MC, Miró Ò, Rossignol P, Metra M, Lassus J, Orso F, Jankowska EA, Chioncel O, Milicic D, Hill L, Seferovic P, Rosano G, Coats A, Damman K. Renal effects of guideline‐directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology. European Journal Of Heart Failure 2022, 24: 603-619. PMID: 35239201, DOI: 10.1002/ejhf.2471.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsChronic heart failureHeart failureRenal functionEjection fractionClinical practiceConsensus documentSodium-glucose cotransporter 2 inhibitorsGuideline-directed medical therapyReduced ejection fraction patientsEjection fraction patientsHeart Failure AssociationCotransporter 2 inhibitorsEuropean SocietyPharmacologic treatment optionsPoor renal functionDisease-modifying therapiesGood clinical practiceTreatment-induced changesDrug implementationHF drugsCardiology guidelinesESC guidelinesRenal effectsMedical therapyLifesaving therapyEvidence-Based Medical Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Chronic Kidney Disease
Beldhuis IE, Lam CSP, Testani JM, Voors AA, Van Spall HGC, Maaten J, Damman K. Evidence-Based Medical Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Chronic Kidney Disease. Circulation 2022, 145: 693-712. PMID: 35226558, PMCID: PMC9074837, DOI: 10.1161/circulationaha.121.052792.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsChronic kidney diseasePresence of CKDSevere chronic kidney diseaseHeart failure hospitalizationReduced ejection fractionHFrEF therapyHeart failureFailure hospitalizationEjection fractionMedical therapyKidney diseaseDrug classesSodium-glucose cotransporter 2 inhibitorsEvidence-based medical therapyGlucose cotransporter 2 inhibitorsStrong independent risk factorEnd pointCKD stage 3bPoor cardiovascular outcomesCKD stage 5Combined end pointCotransporter 2 inhibitorsIndependent risk factorSevere heart failureGlomerular filtration rate
2021
Effect of Sotagliflozin on Total Hospitalizations in Patients With Type 2 Diabetes and Worsening Heart Failure : A Randomized Trial.
Szarek M, Bhatt DL, Steg PG, Cannon CP, Leiter LA, McGuire DK, Lewis JB, Riddle MC, Voors AA, Metra M, Lund LH, Komajda M, Testani JM, Wilcox CS, Ponikowski P, Lopes RD, Banks P, Tesfaye E, Ezekowitz JA, Verma S, Pitt B. Effect of Sotagliflozin on Total Hospitalizations in Patients With Type 2 Diabetes and Worsening Heart Failure : A Randomized Trial. Annals Of Internal Medicine 2021, 174: 1065-1072. PMID: 34152828, DOI: 10.7326/m21-0651.Peer-Reviewed Original ResearchConceptsHeart failurePlacebo groupType 2 diabetesSotagliflozin groupRate of daysSodium-glucose cotransporter 2 inhibitorsEffect of sotagliflozinPrespecified efficacy outcomeWorsening Heart FailureDuration of admissionPlacebo-controlled trialCotransporter 2 inhibitorsPatient-centered outcomesSodium-glucose cotransporter 1Poisson regression modelsCardiovascular deathEfficacy outcomesTotal hospitalizationsUrgent visitsEjection fractionPatients' qualityDisease burdenSotagliflozinHospitalizationPatients
2020
Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure
Bhatt DL, Szarek M, Steg PG, Cannon CP, Leiter LA, McGuire DK, Lewis JB, Riddle MC, Voors AA, Metra M, Lund LH, Komajda M, Testani JM, Wilcox CS, Ponikowski P, Lopes RD, Verma S, Lapuerta P, Pitt B. Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure. New England Journal Of Medicine 2020, 384: 117-128. PMID: 33200892, DOI: 10.1056/nejmoa2030183.Peer-Reviewed Original ResearchConceptsPrimary end-point eventEnd-point eventsHeart failureSotagliflozin groupCardiovascular causesPlacebo groupRate of deathFirst doseUrgent visitsSodium-glucose cotransporter 2 inhibitorsType 2 diabetes mellitusWorsening Heart FailureAcute kidney injuryDecompensated heart failureDouble-blind trialPrimary end pointStable heart failureCotransporter 2 inhibitorsPercentage of patientsRisk of hospitalizationKidney injuryPrespecified subgroupsDiabetes mellitusSevere hypoglycemiaSGLT2 inhibitorsSodium glucose cotransporter 2 inhibitors as diuretic adjuvants in acute decompensated heart failure: a case series
Griffin M, Riello R, Rao VS, Ivey-Miranda J, Fleming J, Maulion C, McCallum W, Sarnak M, Collins S, Inzucchi SE, Testani JM. Sodium glucose cotransporter 2 inhibitors as diuretic adjuvants in acute decompensated heart failure: a case series. ESC Heart Failure 2020, 7: 1966-1971. PMID: 32476296, PMCID: PMC7373933, DOI: 10.1002/ehf2.12759.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureSodium-glucose cotransporter 2 inhibitorsGlucose cotransporter 2 inhibitorsDecompensated heart failureCotransporter 2 inhibitorsType 2 diabetesSGLT-2iBlood pressureHeart failureUrine outputYale-New Haven HospitalWeight lossIncidence of hypokalaemiaSGLT-2i initiationSGLT-2i therapyGlucose-lowering medicationsHeart failure outcomesCohort of patientsAverage weight lossDiuretic dosingDiuretic resistanceAdjunctive therapyWorsened survivalDiuretic efficiencyDiuretic monotherapyEmpagliflozin in Heart Failure
Griffin M, Rao VS, Ivey-Miranda J, Fleming J, Mahoney D, Maulion C, Suda N, Siwakoti K, Ahmad T, Jacoby D, Riello R, Bellumkonda L, Cox Z, Collins S, Jeon S, Turner JM, Wilson FP, Butler J, Inzucchi SE, Testani JM. Empagliflozin in Heart Failure. Circulation 2020, 142: 1028-1039. PMID: 32410463, PMCID: PMC7521417, DOI: 10.1161/circulationaha.120.045691.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsCotransporter 2 inhibitorsNeurohormonal activationHeart failureRenal dysfunctionBlood volumeHeart failure-related outcomesPlacebo-controlled crossover studyType 2 diabetes mellitusProximal tubular siteHeart failure outcomesStable heart failureUrinary glucose excretionUric acid levelsElectrolyte wastingEmpagliflozin monotherapyOral empagliflozinPlacebo periodStudy drugGlucose excretionNatriuretic effectPotassium wastingTubular sitesDiabetes mellitusFractional excretion