SGLT2 Inhibitors, the next GDMT?

Questions regarding the role of sodium-glucose co-transporter-2 inhibitors (SGLT2i) in heart failure have been raised since the publications of EMPA-REG OUTCOME in 2015. The recent results of the Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients With Chronic Heart Failure (DAPA-HF) shed some light on the potential for these medications in HFrEF. In this blog, we discuss the implications of DAPA-HF and the role of SGLT2i for heart failure, including perspectives from a cardiologist.

Aldosterone Receptor Antagonist Use in Heart Failure Patients with End Stage Renal Disease Undergoing Dialysis: Is it Safe?

Cardiovascular disease is the leading cause of morbidity and mortality in patients with end stage renal disease (ESRD). A significant number of patients with ESRD undergoing dialysis have reduced left ventricular ejection fraction. Contemporary treatment of heart failure with reduced ejection fraction (HFrEF) includes multiple pharmacotherapeutic strategies such as renin-angiotensin-aldosterone system inhibitors to reduce mortality and slow disease progression. However, because of concerns about hyperkalemia, aldosterone receptor antagonists are not commonly used in patients with HFrEF and ESRD undergoing dialysis. This blog summarizes the current evidence for efficacy and safety of aldosterone receptor antagonists in patients with concomitant HFrEF and ESRD requiring dialysis.

3 Clinical Pearls For Acute Management of Atrial Fibrillation in Patients with Heart Failure with Reduced Ejection Fraction

Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) often occur concomitantly. Despite this, optimal treatment strategies remain unclear. Current rate and rhythm control pharmacotherapy options present challenges when used in patients with HFrEF. In this blog, we cover 3 clinical pearls to consider for acute management of AF in patients with HFrEF.

Icosapent Ethyl for Prevention of Cardiovascular Disease: Worth the Hype or Fishing for a Place in Therapy?

Omega-3 fatty acids have been associated with lowering TG; however, robust data for clinical outcomes have been lacking until the recent publication of the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT).2,3 This blog will give a brief review of historical evidence, detail differences in fish oil supplements, and provide considerations for the role of Vascepa (icosapent ethyl) in high-risk patients with dyslipidemia.

Hydralazine-nitrate combination for heart failure with a reduced ejection fraction – does formulation matter?

Teaser: Does the formulation of oral nitrate therapy matter when used for patients with heart failure with reduced ejection fraction (HFrEF)? Should fixed-dose hydralazine (HYD)/isosorbide dinitrate (ISDN) (BiDil®) be used in those with HFrEF or can the medications be prescribed separately? In clinical practice the individual components HYD and ISDN are often prescribed as a result of cost concerns with the brand name, fixed-dose combination product. Additionally, clinicians often substitute extended-release isosorbide mononitrate (ISMN) for ISDN given its less frequent administration schedule. In this post we will discuss whether these formulations can be used interchangeably in those with HFrEF.