Cardio Trial Files: Beta Blockers Post-ACS, GLP1 for Heart Failure, and Empa Post-MI
Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction
Yndigegn T et al. NEJM (April 2024)
Bottom Line: This parallel-group, open-label clinical trial enrolled 5020 patients with acute myocardial infarction and preserved left ventricular ejection fraction (≥50%) from September 2017 to May 2023. Patients were randomly assigned to receive long-term beta-blocker treatment or no beta-blocker treatment. The primary outcome was a composite of death from any cause or new myocardial infarction over a median follow-up of 3.5 years. Results showed no significant difference in the primary outcome between the two groups. There were also no significant differences in safety outcomes. Therefore, long-term beta-blocker treatment did not provide a benefit in reducing the risk of death or new myocardial infarction in this patient population.
Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes
Kosiborod MN et al. NEJM (April 2024)
Bottom Line: This randomized controlled trial evaluated the effects of semaglutide (2.4 mg) versus placebo in 529 patients with heart failure with preserved ejection fraction and obesity. The study duration was 52 weeks and blinding was not mentioned. The patient population had a mean body-mass index of 30 or higher. The primary outcomes were improvements in the Kansas City Cardiomyopathy Questionnaire clinical summary score and weight loss. Semaglutide led to significantly greater improvements in both outcomes compared to placebo. Safety outcomes showed a lower incidence of serious adverse events in the semaglutide group. The study concluded that semaglutide was more effective in reducing symptoms, improving exercise function, and promoting weight loss in this patient population.
Empagliflozin after Acute Myocardial Infarction
Butler J et al. NEJM (April 2024)
Bottom Line: This was an event-driven, double-blind, randomized, placebo-controlled trial assessing empagliflozin's efficacy in reducing heart failure or death post-acute myocardial infarction. A total of 6522 patients were randomized 1:1 to receive either empagliflozin or placebo. Primary outcome analysis showed no significant difference between groups for the composite endpoint of heart failure hospitalization or death. Safety profiles were consistent with previous knowledge. The conclusion suggests empagliflozin did not significantly reduce the risk of adverse outcomes in this population.
Cardio Trial Files Issue #CRD-2024-08
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