Publications by authors named "Cohen-Solal A"
Article Synopsis
- A study looked at how steroids, like prednisone, help reduce congestion in patients with acute heart failure (AHF).
- Patients taking prednisone showed more improvement in their congestion levels compared to those receiving regular care.
- The results suggest that steroids can help with symptoms related to congestion, but more research is needed to confirm these findings.
Article Synopsis
- - Anemia is a common issue among heart failure patients, affecting their treatment outcomes, and this study aimed to examine how anemia prevalence changes and its relationship with clinical results in heart failure patients from the STRONG-HF study.
- - In the study of 1077 patients, anemia rates rose from 27.2% at enrollment to 32.1% at 90 days, with a slightly higher primary composite outcome observed in anemic patients, but the difference wasn't statistically significant.
- - Patients with baseline anemia showed less improvement in health-related quality of life, while the incidence of anemia was higher in those receiving high-intensity care compared to usual care; factors like male sex and non-European regions were linked to a higher
Article Synopsis
- * Patients receiving prednisone showed a significant reduction in inflammation as indicated by decreased levels of high-sensitivity C-reactive protein (hsCRP) and a notably lower risk of heart failure worsening, readmissions, or death over 90 days compared to the usual care group.
- * While burst steroid therapy improved outcomes like quality of life and reduced heart failure risks, it was associated with more adverse events like hyperglycemia, indicating a need for larger studies to confirm these findings and further assess safety
Article Synopsis
- - The study evaluated the effectiveness of patiromer, a drug used to manage high potassium levels (hyperkalemia), in patients with heart failure and chronic kidney disease, especially focusing on its benefits when used alongside RAAS inhibitors.
- - Results showed that patiromer was particularly effective in controlling serum potassium levels in patients with more advanced chronic kidney disease (CKD), without increasing the risk of adverse effects.
- - The research concluded that patiromer allows for safer use of RAAS inhibitors in patients with heart failure, especially those with lower estimated glomerular filtration rates (eGFR), while minimizing hyperkalemia risk.
Background: Rapid uptitration of guideline-directed medical therapy (GDMT) before and after discharge in hospitalized heart failure (HF) patients is feasible, is safe, and improves outcomes; whether this is also true in patients with coexistent atrial fibrillation/flutter (AF/AFL) is not known.
Objectives: This study sought to investigate whether rapid GDMT uptitration before and after discharge for HF is feasible, safe and beneficial in patients with and without AF/AFL.
Methods: In this secondary analysis of the STRONG-HF (Safety, Tolerability, and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies) trial, GDMT uptitration and patient outcomes were analyzed by AF/AFL status and type (permanent, persistent, paroxysmal).
Article Synopsis
- Immunological therapies, including immune checkpoint inhibitors (ICIs) and cell-based therapies like CAR-T, have transformed cancer treatment by enabling the immune system to target cancer cells.
- While these therapies are generally effective, they can cause immune-related adverse events (irAEs) that vary in severity and timing, from mild skin rashes to serious complications such as myocarditis or cytokine release syndrome.
- The statement discusses the growing understanding of cardiovascular toxicities associated with these therapies, outlines their diagnosis and management, and identifies gaps in current research that need further exploration.
Article Synopsis
- The STRONG-HF trial tested the effectiveness of rapidly increasing neurohormonal blockade in patients with acute heart failure (AHF) compared to usual care.
- Patients receiving high-intensity care (HIC) showed significantly higher rates of successful decongestion at day 90 (75%) compared to usual care (68%), alongside improvements in various decongestion markers.
- Successful decongestion was linked to a lower risk of hospital readmission or all-cause death, indicating that the HIC approach offers better long-term outcomes for AHF patients.
Article Synopsis
- Heart transplantation (HTx) has been around for over 50 years, yet there's a lack of guidelines for post-transplant prevention and rehabilitation practices.
- The statement emphasizes the need for tailored prevention and rehabilitation programs that consider both modifiable and non-modifiable factors to enhance the physical capacity and quality of life for HTx recipients.
- It advocates for a multidisciplinary approach involving all members of the HTx team to support patients throughout their recovery journey, highlighting the importance of starting these programs early after transplantation.
Aims: Inflammation has emerged as a potential key pathophysiological mechanism in heart failure (HF) in general and acute HF (AHF) specifically, with inflammatory biomarkers shown to be highly predictive of adverse outcomes in these patients. The CORTAHF study builds on both these data and the fact that steroid burst therapy has been shown to be effective in the treatment of respiratory diseases and COVID-19. Our hypothesis is that in patients with AHF and elevated C-reactive protein (CRP) levels without symptoms or signs of infection, a 7-day course of steroid therapy will lead to reduced inflammation and short-term improvement in quality of life and a reduced risk of worsening HF (WHF) events.
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- The text highlights a lack of knowledge and guidelines on physical activity and lifestyle measures for heart transplantation (HTx) recipients, despite the procedure's long history.
- It emphasizes the need for tailored prevention and rehabilitation strategies to enhance physical capacity, quality of life, and survival for these patients.
- The statement calls for a multidisciplinary approach to care, starting early post-transplant and continuing throughout the patients' journey, as HTx recipients have unique rehabilitation needs compared to other heart-related patients.
Article Synopsis
- Limited information exists on the physical activity and lifestyle measures for heart transplantation (HTx) recipients, despite the history of HTx spanning over 50 years without established guidelines for prevention and rehabilitation.
- The scientific statement aims to highlight the significance of prevention and rehabilitation post-HTx and identify both modifiable and non-modifiable factors that can enhance physical capacity, quality of life, and survival for these patients.
- A multidisciplinary approach is essential for developing tailored prevention and rehabilitation programs that begin early after HTx and continue throughout the patient's recovery journey.
Article Synopsis
- - Biologically active adrenomedullin (bio-ADM) has potential as a marker for residual congestion in heart failure (HF) patients, as shown in the STRONG-HF trial, which indicated that high-intensity care of guideline-directed medical therapy can improve patient outcomes.
- - A study measuring bio-ADM levels in 1,005 heart failure patients found that higher baseline bio-ADM concentrations were linked to increased risks of mortality and rehospitalization, while bio-ADM changes correlated with congestion status after 90 days.
- - Although bio-ADM showed modest predictive ability for patient outcomes, the study found that high-intensity care improved outcomes regardless of initial bio-ADM levels, and its change over 90
Right heart failure (RHF) following implantation of a left ventricular assist device (LVAD) is a common and potentially serious condition with a wide spectrum of clinical presentations with an unfavourable effect on patient outcomes. Clinical scores that predict the occurrence of right ventricular (RV) failure have included multiple clinical, biochemical, imaging and haemodynamic parameters. However, unless the right ventricle is overtly dysfunctional with end-organ involvement, prediction of RHF post-LVAD implantation is, in most cases, difficult and inaccurate.
View Article and Find Full Text PDFBackground: The STRONG-HF trial showed that high-intensity care (HIC) consisting of rapid up-titration of guideline-directed medical therapy (GDMT) and close follow-up reduced all-cause death or heart failure (HF) readmission at 180 days compared to usual care (UC). We hypothesized that significant differences in patient characteristics, management, and outcomes over the enrolment period may exist.
Methods: Two groups of the 1,078 patients enrolled in STRONG-HF were created according to the order of enrolment within center.
Article Synopsis
- The study investigates the safety, tolerability, and efficacy of high-intensity care (HIC) for heart failure using the MAGGIC risk score, which is a risk assessment tool for patients with chronic heart failure.
- Patients in the STRONG-HF trial were divided into two groups, one receiving HIC with rapid medication uptitration and the other receiving usual care, with the main goal of comparing outcomes such as death and hospitalization rates at 180 days.
- Results showed that while HIC led to higher medication use, the overall death or readmission rates varied according to the MAGGIC risk score, suggesting that the severity of heart failure risk impacts treatment outcomes.
Background: This analysis provides details on baseline and changes in quality of life (QoL) and its components as measured by EQ-5D-5L questionnaire, as well as association with objective outcomes, applying high-intensity heart failure (HF) care in patients with acute HF.
Methods: In STRONG-HF trial (Safety, Tolerability, and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies) patients with acute HF were randomized just before discharge to either usual care or a high-intensity care strategy of guideline-directed medical therapy up-titration. Patients ranked their state of health on the EQ-5D visual analog scale score ranging from 0 (the worst imaginable health) to 100 (the best imaginable health) at baseline and at 90 days follow-up.
Article Synopsis
- - The study investigates the effectiveness of a high-intensity care (HIC) strategy with rapid guideline-directed medical therapy (GDMT) compared to usual care (UC) for patients hospitalized due to acute heart failure (AHF) and examines the influence of baseline systolic blood pressure (SBP).
- - Researchers analyzed the outcomes of 1,075 patients categorized by their baseline SBP and changes in SBP after discharge, finding that the benefits of HIC were not influenced by baseline SBP levels or early changes in SBP.
- - Results showed that patients in the HIC group achieved similar target doses of GDMT regardless of whether they had increased, stable, or decreased SBP within the first week after discharge,
Article Synopsis
- Implantable devices help patients with heart failure by working alongside medicines to treat the condition and improve their health.
- While some devices are supported by strong evidence and show positive effects, others need more research before they can be widely used.
- The Heart Failure Association and European Heart Rhythm Association suggest a better way to use these devices in care programs to help patients more effectively.
In heart failure patients with reduced ejection fraction, Sacubitril/valsartan (S/V) increased proBNP T71 glycosylation, which is regulated negatively by hypoxia via miR-30a . Using a cohort of 73 HFrEF patients who were transitioned from standard HF medication to S/V, we found that the increase in proBNP T71 glycosylation after S/V was associated with a decrease in cardiac hypoxia. We further found that plasma levels of K709-acteylated HIF1α, HIF-regulated and HIF-independent biomarkers also evolved consistently with a decrease in hypoxia.
View Article and Find Full Text PDFImportance: The Safety, Tolerability, and Efficacy of Rapid Optimization, Helped by N-Terminal Pro-Brain Natriuretic Peptide Testing of Heart Failure Therapies (STRONG-HF) trial strived for rapid uptitration aiming to reach 100% optimal doses of guideline-directed medical therapy (GDMT) within 2 weeks after discharge from an acute heart failure (AHF) admission.
Objective: To assess the association between degree of GDMT doses achieved in high-intensity care and outcomes.
Design, Setting, And Participants: This was a post hoc secondary analysis of the STRONG-HF randomized clinical trial, conducted from May 2018 to September 2022.
Cardio-oncology is a rapidly growing field of cardiovascular (CV) medicine that has resulted from the continuously increasing clinical demand for specialized CV evaluation, prevention and management of patients suffering or surviving from malignant diseases. Dealing with CV disease in patients with cancer requires special knowledge beyond that included in the general core curriculum for cardiology. Therefore, the European Society of Cardiology (ESC) has developed a special core curriculum for cardio-oncology, a consensus document that defines the level of experience and knowledge required for cardiologists in this particular field.
View Article and Find Full Text PDFAim: In this subgroup analysis of STRONG-HF, we explored the association between changes in renal function and efficacy of rapid up-titration of guideline-directed medical therapy (GDMT) according to a high-intensity care (HIC) strategy.
Methods And Results: In patients randomized to the HIC arm (n = 542), renal function was assessed at baseline and during follow-up visits. We studied the association with clinical characteristics and outcomes of a decrease in estimated glomerular filtration rate (eGFR) at week 1, defined as ≥15% decrease from baseline.
Background: Safety, Tolerability and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies (STRONG-HF) demonstrated the safety and efficacy of rapid up-titration of guideline-directed medical therapy (GDMT) with high-intensity care (HIC) compared with usual care in patients hospitalized for acute heart failure (HF). In the HIC group, the following safety indicators were used to guide up-titration: estimated glomerular filtration rate of <30 mL/min/1.73 m, serum potassium of >5.
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