Clin-STAR corner: Practice changing advances in cardiology

Area of Science:

• Cardiology
• Geriatrics
• Clinical Trials

Background:

• Cardiovascular disease is a leading cause of death and disability in older adults.
• Older adults are under-represented in cardiovascular clinical trials, limiting evidence-based care.

Purpose of the Study:

• To summarize recent (2020-2022) practice-changing cardiovascular trial findings directly applicable to older adults.
• To highlight key implications for managing cardiovascular conditions in geriatric populations.

Main Methods:

• Review of four cardiovascular clinical trials published between 2020 and 2022.
• Focus on trials with direct relevance and implications for the care of older patients.

Main Results:

• A conservative management strategy is reasonable for selected patients with stable ischemic heart disease, even with moderate to severe ischemia.
• Empagliflozin significantly reduces heart failure hospitalizations in patients with heart failure and preserved ejection fraction, irrespective of diabetes status.
• Tailored physical rehabilitation programs improve outcomes for older patients hospitalized with heart failure, reducing deconditioning and functional decline.
• Restricting dietary sodium intake to <1500 mg/day is unlikely to improve outcomes for most heart failure patients.

Conclusions:

• Recent cardiovascular trials offer significant advancements in the care of older adults.
• Evidence supports conservative management, specific pharmacotherapy (empagliflozin), and rehabilitation for improved cardiovascular outcomes in older populations.
• Dietary sodium restriction may not be universally beneficial for heart failure management in this demographic.