508 results match your criteria: "Cardiovascular and Renal Clinical Trialists[Affiliation]"

Reaffirmation of Mechanistic Proteomic Signatures Accompanying SGLT2 Inhibition in Patients With Heart Failure: A Validation Cohort of the EMPEROR Program.

J Am Coll Cardiol

November 2024

Centre d'Investigations Cliniques Plurithématique 1433, INSERM, Université de Lorraine, Nancy, France; F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), INSERM U1116, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France.

Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors exert a distinctive pattern of direct biological effects on the heart and kidney under experimental conditions, but the meaningfulness of these signatures for patients with heart failure has not been fully defined.

Objectives: We performed the first mechanistic validation study of large-scale proteomics in a double-blind randomized trial of any treatment in patients with heart failure.

Methods: In a discovery cohort from the EMPEROR (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure and Reduced Ejection Fraction) program, we studied the effect of randomized treatment with placebo or empagliflozin on 1,283 circulating proteins in 1,134 patients with heart failure with a reduced or preserved ejection fraction.

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Where Are Patients' Voices in Chronic Kidney Disease?

Clin J Am Soc Nephrol

November 2024

Université de Lorraine, Centre d'Investigations Cliniques-Plurithématique 14-33, Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.

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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.
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Article Synopsis
  • The study aims to identify biomarkers linked to new-onset kidney function decline in initially healthy individuals, ultimately improving patient management.
  • It analyzed data from 1,087 participants over a 20-year period, focusing on the relationship between proteins and gene expressions and changes in glomerular filtration rate (GFR).
  • Key findings included several proteins and genes associated with kidney dysfunction, highlighting the roles of extracellular matrix, cardiovascular remodeling, and inflammation in early GFR decline and suggesting potential avenues for future research in biomarkers and treatments.
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Should the SELECT Trial Make Us Comfortable Using GLP-1 Receptor Agonists in HFrEF?

J Am Coll Cardiol

September 2024

Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Université de Lorraine, Inserm, Centre d'Investigations Cliniques-Plurithématique, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France; Heart Failure Clinic, Internal Medicine Department, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, Portugal.

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Efficacy and safety of SGLT2 inhibitors with and without glucagon-like peptide 1 receptor agonists: a SMART-C collaborative meta-analysis of randomised controlled trials.

Lancet Diabetes Endocrinol

August 2024

Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands; The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia. Electronic address:

Article Synopsis
  • SGLT2 inhibitors and GLP-1 receptor agonists both have positive effects on cardiovascular and kidney health in patients with type 2 diabetes, leading to a study comparing their benefits when used together or separately.
  • A meta-analysis from various trials showed that SGLT2 inhibitors effectively reduced risks of major cardiovascular events and kidney disease progression for patients whether or not they were taking GLP-1 receptor agonists.
  • The consistency of these benefits across different outcomes indicates that SGLT2 inhibitors can be beneficial for all diabetic patients, regardless of GLP-1 receptor agonist usage.
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Background And Hypothesis: Heart failure is characterized as cardiac dysfunction resulting in elevated cardiac filling pressures with symptoms and signs of congestion. Distinguishing heart failure from other causes of similar presentations in patients with kidney failure is challenging but necessary, and is needed in randomized controlled trials (RCTs) to accurately estimate treatment effects. The objective of this study was to review heart failure events, their diagnostic criteria and adjudication in RCTs of patients with kidney failure treated with dialysis.

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Proteomics for understanding progression to heart failure in chronic kidney disease: promising but still not there.

Eur Heart J

August 2024

Centre d'Investigations Cliniques Plurithématique 1433, INSERM, Université de Lorraine, CIC 1439, Institut Lorrain du Coeur et des Vaisseaux, CHU 54500, Vandoeuvre-lès-Nancy, Nancy, France.

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Aims: Patients hospitalized for acute heart failure (HF) could be enrolled in EMPULSE (NCT04157751) upon haemodynamic stabilization and between 24 h and 5 days after hospital admission. The timing of treatment initiation may influence the efficacy and safety of drugs such as empagliflozin. The aim of this study was to evaluate patient characteristics, clinical events, and treatment effects according to time from admission to randomization.

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Office- versus home-based evaluation of quality of life in heart failure with reduced ejection fraction: A randomized study.

Int J Cardiol

October 2024

Cardiovascular Research and Development Center (UnIC@RISE), Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal; Institut National de la Santé et de la Recherche Médicale U1116, Centre Hospitalier Régional Universitaire, French Clinical Research Infrastructure Network, Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists, Nancy, France. Electronic address:

Background: Heart failure (HF) patients often experience poor health-related quality-of-life (HR-QoL). The Kansas City Cardiomyopathy Questionnaire (KCCQ) is frequently used for assessing HR-QoL in HF. Whether KCCQ scores vary in a clinical meaningful manner according to the setting (home vs office) where patients respond to the questionnaire is currently unknown.

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Article Synopsis
  • Iron deficiency (ID) is prevalent in heart failure (HF) patients and negatively impacts their health, even if they aren't anemic; iron supplementation can improve exercise and quality of life in these individuals.
  • An online survey of 256 cardiologists revealed that most defined ID correctly and screened more than half of their patients, but only 54.3% did periodic screenings; intravenous iron was the most commonly prescribed treatment.
  • The survey results point to a need for better, standardized practices for ID screening and management in HF patients, as many physicians view ID as an overlooked issue in this group.
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Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed.

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Low Natriuretic Peptide Levels and Outcomes in Patients With Heart Failure and Preserved Ejection Fraction.

JACC Heart Fail

August 2024

British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom. Electronic address:

Background: Although some patients with heart failure (HF) with mildly reduced/preserved ejection fraction have low natriuretic peptide levels, there are no large-scale systematic studies of how common these individuals are or what happens to them.

Objectives: The purpose of this study was to examine the proportion of patients in the I-PRESERVE (Irbesartan in Heart Failure with Preserved Ejection Fraction) trial with an N-terminal pro-B-type natriuretic peptide (NT-proBNP) level <125 pg/mL, their clinical characteristics, and outcomes.

Methods: I- PRESERVE enrolled patients with symptomatic HF and a LVEF ≥45% but who did not have NT-proBNP or body mass index inclusion/exclusion criteria.

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Aims: Patients with heart failure (HF) display metabolic alterations, including heightened ketogenesis, resulting in increased beta-hydroxybutyrate (β-OHB) formation. We aimed to investigate the determinants and prognostic impact of circulating β-OHB levels in patients with advanced HF and reduced ejection fraction (HFrEF).

Methods And Results: A total of 867 patients with advanced HFrEF (age 57 ± 11 years, 83% male, 45% diabetic, 60% New York Heart Association class III), underwent clinical and echocardiographic examination, circulating metabolite assessment, and right heart catheterization (n = 383).

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Article Synopsis
  • - The study investigated whether the heart failure medication sacubitril/valsartan could lead to cognitive impairment, as it affects enzymes that degrade amyloid-β peptides, which are linked to Alzheimer's disease.
  • - Researchers used the Mini-Mental State Examination (MMSE) to assess cognitive function changes over 96 weeks in a subset of heart failure patients from the PARAGON-HF trial, comparing those on sacubitril/valsartan to those on valsartan alone.
  • - Results showed no significant difference in cognitive decline between the two groups, with both medications resulting in nearly identical changes in MMSE scores, suggesting sacubitril/valsartan does not have a negative effect on cognitive function in these patients. *
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A machine learning-based lung ultrasound algorithm for the diagnosis of acute heart failure.

Intern Emerg Med

November 2024

Université de Lorraine, Centre D'Investigation Clinique-Plurithématique Inserm CIC-P 1433, Inserm U1116, CHRU Nancy Hopitaux de Brabois, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Institut Lorrain du Coeur Et Des Vaisseaux Louis Mathieu, 4 Rue du Morvan, 54500, Vandoeuvre Lès Nancy, France.

Lung ultrasound (LUS) is an effective tool for diagnosing acute heart failure (AHF). However, several imaging protocols currently exist and how to best use LUS remains undefined. We aimed at developing a lung ultrasound-based model for AHF diagnosis using machine learning.

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Hypothermia in patients with cardiac arrest prior to ECMO-VA: Insight from the HYPO-ECMO trial.

Resuscitation

July 2024

Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et des Vaisseaux, Nancy, France; INI-CRCT (Cardiovascular and Renal Clinical Trialists), F-CRIN Network, Nancy, France; REICATRA, Université de Lorraine, Nancy, France.

Article Synopsis
  • The HYPO-ECMO trial evaluated the effects of moderate hypothermia (MH) versus normothermia in patients with cardiogenic shock (CS) and cardiac arrest (CA) treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO).
  • The study analyzed data from 334 intubated patients and found that 48% had experienced CA; mortality rates were higher in the CA group compared to those without CA.
  • Results indicated that MH significantly reduced mortality and improved outcomes for patients with CA, suggesting its potential benefit in this high-risk subgroup, though further research is required for confirmation.
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Hemodynamic Support in Sepsis.

Anesthesiology

June 2024

Department of Anesthesia and Perioperative Care, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, California; INI-CRCT (Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists) Network, Nancy, France.

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Diuresis Efficacy in Ambulatory Congested Heart Failure Patients: Intrapatient Comparison of 3 Diuretic Regimens (DEA-HF).

JACC Heart Fail

August 2024

Heart Failure Unit, Department of Cardiology and the Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; Clinical Research Institute at Rambam (CRIR), Haifa, Israel. Electronic address:

Background: Limited evidence exists regarding efficacy and safety of diuretic regimens in ambulatory, congestion-refractory, chronic heart failure (CHF) patients.

Objectives: The authors sought to compare the potency and safety of commonly used diuretic regimens in CHF patients.

Methods: A prospective, randomized, open-label, crossover study conducted in NYHA functional class II to IV CHF patients, treated in an ambulatory day-care unit.

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Steatotic liver disease (SLD) is a worldwide public health problem, causing considerable morbidity and mortality. Patients with SLD are at increased risk for major adverse cardiovascular (CV) events, type 2 diabetes mellitus and chronic kidney disease. Conversely, patients with cardiometabolic conditions have a high prevalence of SLD.

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Hypertensive disorders in pregnancy (HDP), remain the leading cause of adverse maternal, fetal, and neonatal outcomes. Epidemiological factors, comorbidities, assisted reproduction techniques, placental disorders, and genetic predisposition determine the burden of the disease. The pathophysiological substrate and the clinical presentation of HDP are multifarious.

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Aims: Insulin-like growth factor binding protein-7 (IGFBP7) is a biomarker of tissue senescence with a role in cardio-renal pathophysiology. The role of IGFBP7 as a prognostic biomarker across the full ejection fraction (EF) spectrum of heart failure (HF) remains less well understood. We examined associations between IGFBP7 and risk of cardio-renal outcomes regardless of EF and the effect of empagliflozin treatment on IGFBP7 concentrations among individuals with HF.

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