Cardiology Month in Review: August 2024

As August 2024 comes to a close, the cardiology world reflects on a whirlwind of updates from the European Society of Cardiology (ESC) Congress 24, marking another milestone in an already groundbreaking year. With significant advancements in cardiovascular treatments already achieved in the first half of the year—such as semaglutide for reducing cardiovascular risk in obesity and the approval of bempedoic acid for primary prevention—the summer continued to build on this momentum. The ESC congress offered a platform for unveiling pivotal clinical trial results and discussing novel therapeutic strategies, solidifying 2024 as a year of transformation in the field.

In this cardiology news roundup for August 2024, we delve into the major findings presented at the ESC Congress and beyond. The congress highlighted pivotal clinical trials that could reshape cardiovascular treatment strategies. Key topics included the reevaluation of beta-blocker use post-myocardial infarction, advancements in long-term cardiovascular risk prediction for women, new therapies improving outcomes in transthyretin amyloid cardiomyopathy (ATTR-CM) and familial chylomicronemia syndrome (FCS), and guidance on the management of medications like RAS inhibitors before major surgery.

ESC Congress

ESC Congress Recap: High-Impact Clinical Trials, with Deepak Bhatt, MD, MPH, MBA

HCPLive Cardiology sat down with Deepak Bhatt, MD, MPH, MBA, director of Mount Sinai Heart, and Dr. Valentin Foster Professor of Cardiovascular Medicine at the Icahn School of Medicine, for his post-conference perspective on the meeting’s top trials and new data releases. In the featured video, Bhatt highlights a group of 4 studies from the meeting, including FINEARTS-HF, ABYSS, RESHAPE-HF2, and SHAM-PVI.

• ABYSS Trial: No Difference in Outcomes Continuing or Stopping Beta-Blockers Following MI

The ABYSS trial suggests no clear benefit of continuing beta-blockers post-MI in patients with preserved LVEF, echoing REDUCE-AMI findings.

• Single Blood Test Could Predict Cardiovascular, Stroke Risk in Women for Up to 30 Years

A single blood test using hsCRP, LDL-C, and Lp(a) levels can predict cardiovascular risk for women up to 30 years, emphasizing personalized care.

• Vutrisiran Reduces Cardiovascular Risk, Improves Quality of Life in ATTR-CM

HELIOS-B trial shows vutrisiran reduces all-cause mortality and CV events in ATTR-CM, with benefits consistent regardless of tafamidis use.

• STOP-or-NOT: No Benefit to Discontinuing RASi Prior to Major Surgery

The STOP-or-NOT trial found similar outcomes for continuation or discontinuation of RAS inhibitors before noncardiac surgery, supporting individualized decision-making.

• PALISADE: Plozasiran Offers Hope for Treating Familial Chylomicronemia Syndrome

ESC 2024: Phase 3 PALISADE trial shows plozasiran significantly lowers triglycerides and pancreatitis risk in FCS; NDA planned by year-end.

Finerenone Updates

Topline Data Prove Finerenone's HFpEF Benefit in FINEARTS-HF Trial

Finerenone (Kerendia) met its primary endpoint in the FINEARTS-HF trial, showing a significant reduction in the composite of cardiovascular death and total heart failure, according to an August 5, 2024 announcement from Bayer.

Already boasting US Food and Drug Administration (FDA) approvals for chronic kidney disease in patients with type 2 diabetes (T2D), topline data from the FINEARTS-HF trial signal a new role in the management of another cardiometabolic disease could come soon.

FINEARTS-HF: Finerenone Could Find Role as Second Pillar in HFmrEF/HFpEF

Full results from the FINEARTS-HF trial, presented at ESC 24, suggest finerenone may join SGLT2 inhibitors as a second pillar in treating heart failure with left ventricular ejection fraction (LVEF) greater than 40%. In the trial, finerenone showed a statistically significant 16% relative reduction in total heart failure events.

“We have 4 pillars of guideline-directed medical therapy in HFrEF but only SGLT2 inhibitors as a treatment option for HFmrEF/HFpEF," said Scott Solomon, MD, director of noninvasive cardiology and senior physician at Brigham and Women’s Hospital. "Given that finerenone was beneficial in patients already receiving an SGLT2 inhibitor, our findings point to finerenone as a new second pillar in HFmrEF/HFpEF.”

Don't Miss a Beat: Finerenone's Role in Heart Failure from ESC Congress Data

At ESC 24, Stephen Greene, MD, an advanced heart failure specialist at Duke University School of Medicine, discusses the prospect of finerenone in treatment algorithms for heart failure with Muthiah Vaduganathan, MD, MPH, codirector of the Center for Cardiometabolic Implementation Science of Brigham and Women’s Hospital, who served as an investigator on the FINEARTS-HF trial and presenter of FINE-HEART.