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Contemporary clinical trial updates in heart failure
Monique R Robinson1, Guilherme H Oliveira
1Section of Advanced Heart Failure and Transplantation, Harrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio, USA.
Current Opinion in Cardiology
|June 4, 2016
Summary
New heart failure treatments show promise, including sacubitril/valsartan for reduced ejection fraction and exploring new options for preserved ejection fraction. Advances in mechanical support and gene therapy offer expanded therapeutic strategies for cardiovascular outcomes.
Area of Science:
- Cardiology
- Pharmacotherapy
- Medical Devices
Background:
- Heart failure is a leading cause of cardiovascular disease globally, necessitating continuous advancements in treatment strategies.
- Current management involves medical and surgical interventions aimed at improving patient outcomes.
- Ongoing research seeks deeper pathophysiologic understanding and novel therapeutic approaches.
Purpose of the Study:
- To review recent advancements in heart failure management, focusing on pharmacotherapy, device-based interventions, and emerging treatments.
- To evaluate the efficacy and implications of new therapeutic agents and strategies for heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).
- To discuss the impact of contemporary clinical trials on current clinical practice and future directions in heart failure care.
Main Methods:
- Review of pivotal contemporary clinical trials and studies in heart failure management.
- Analysis of pharmacologic interventions, including sacubitril/valsartan and the role of nitrates.
- Evaluation of non-pharmacologic approaches such as antimicrobial therapy for Chagas' cardiomyopathy, iron supplementation, spinal cord stimulation, gene therapy, and left ventricular assist devices.
Main Results:
- Sacubitril/valsartan demonstrated a mortality benefit in patients with heart failure with reduced ejection fraction (HFrEF).
- Nitrates were found to have a negative effect in patients with heart failure with preserved ejection fraction (HFpEF).
- Progress in durable mechanical circulatory support and non-pharmacological therapies expands treatment options for heart failure.
Conclusions:
- Contemporary trials are significantly influencing bedside management of heart failure.
- Novel insights from trials on sacubitril/valsartan and nitrates are reshaping treatment paradigms for HFrEF and HFpEF.
- Advancements in mechanical support and non-pharmacological approaches provide a broader spectrum of therapeutic choices for heart failure patients.
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