Each month, our editorial staff compiles a recap of the top news in cardiology from the past month. Our April 2023 month in review features new data and documents related to heart failure management, recaps and forecasts of top regulatory decisions, and other top news!
Since the turn of the century, heart failure specialists, and care providers as a whole, have been the beneficiaries of revolutionary advances in the management of heart failure. Our list of most popular content from April 2023 is representative of these advances, featuring multiple studies and documents centered around better understanding contemporary data and management strategies for heart failure.
In April, the American College of Cardiology took aim at furthering care of heart failure with preserved ejection fraction (HFpEF) with the simultaneous publishing of an Expert Clinical Decision Pathway and scientific statement in the Journal of the American College of Cardiology on April 19, 2023. With an interest in learning more about contemporary challenges in management, our editorial team sat down for a Q&A with chair of the expert clinical decision pathway’s writing committee Michelle Kittleson, MD, PhD, director of Heart Failure Research at Smidt Heart Institute at Cedars-Sinai.
Perhaps the most significant advance in heart failure management, and arguably cardiology, in the last decade, SGLT2 inhibitors have proven benefit for heart failure in a multitude of clinical trials across a variety of patient populations. Still, despite the demonstrated efficacy and safety, optimal uptake remains a challenge for the field. In a new study, using data from 4 major phase 3 trials and the Global Burden of Disease Report, a team of investigators concluded more than 49 million patients worldwide were eligible for SGLT2 inhibitor prescription and optimal uptake across the spectrum of ejection fraction could prevent or postpone between 7-8 million total worsening heart failure events and cardiovascular deaths during a 3-year period.
The need to address inequities in care is a theme across all fields in medicine and not unique to cardiology, the cardiology community and leading organizations have sought to confront these inequities. An example of this is the American Heart Association (AHA)’s Get With The Guidelines-HF (GWTG-HF) program and, in late April, new data from hospitals within the registry underlined the impact of such programs. Results of the study indicated quality of heart failure care was equitable for 11 of 14 evidence-based clinical care measures and no in-hospital disparities were observed for hospitals with high proportions of Black patients compared against other hospitals within the program.
In our list of the top decisions to watch for Q2 2023, agents for cardiovascular conditions claim 2 of our top 5 spots. Another potential addition to the armamentarium for heart failure, a forecasted decision on SGLT1/2 inhibitor sotagliflozin is expected in the month of May 2023. Also included in the list is the first-in-class myosin inhibitor mavacamten, which is up for an expanded indication to reduce patient need for septal reduction therapy in patients with obstructive hypertrophic cardiomyopathy.
Our recap of top news from Q1 of 2023 featured a slew of novel drug approvals and game-changing agents in multiple fields, but the top headline for cardiology was Cytokinetic’s receipt of a Complete Response Letter for omecamtiv mecarbil in heart failure and subsequent announcement they would be forgoing further efforts to explore use of the agent to focus on the development of aficamten.
The understanding and emphasis on the relationship between cardiovascular and nephrotic health has received more and more recognition in recent years. With this, specialists in both fields have begun to rely on one another more than ever before when it comes to management of patients with cardiometabolic conditions. In their most recent column, Kim Zuber, PA-C, and Jane Davis, DNP,take a deep dive into use of direct oral anticoagulants in management of chronic kidney disease through the lens of KDIGO guidance and leveraging their real-world perspective.
Data from a phase 4 trial shed new light on the effects of PCSK9 inhibition on plaque burden. Named the ARCHITECT study, the open-label, single-arm trial enrolled patients from the SAFEHEART registry and concluded use of alirocumab significantly reduced both LDL-C and coronary plaque burden, with additional analyses shedding light on the specific effects on different markers of atherosclerosis.
New research from a King’s College London-led team called attention to an increased likelihood of dyslipidemia and cardiovascular events observed among people with late-onset psoriatic arthritis was among our most popular pieces of content during the month of April 2023. An analysis of data from patients presented to a pair of clinics in Greece over a 5-year period, the study included data from 281 patients with psoriatic arthritis and concluded people with later onset of psoriatic arthritis were at an increased likelihood for enthesitis (Adjusted odds ratio [aOR], 0.35 [95% confidence interval [CI], 0.13-0.97]), dyslipidemia (aOR, 3.01 [95% CI, 1.30-6.95]) and major adverse cardiovascular events (aOR, 4.30 [95% CI, 1.42-12.98]) relative to their counterparts in the earlier-onset group.