Cardiology Month in Review: April 2022

Most Popular Stories of April 2022

1. New ACC/AHA/HFSA Heart Failure Guidelines

  • Published on April 1, the new guidelines were created to replace previous guidance published in 2013 and 2017.
  • Highlights from the guideline include revisions to the ACC/AHA heart failure stages and an increased emphasis on SGLT2 inhibitor use.
  • Writing committee provided 10 top take-home messages, which included SGLT2 inhibitors being a part of GDMT for HFrEF and carrying a Class 2a recommendation in both HFpEF and HFmrEF.

2. TAVR vs. SAVR for SVD

  • An ACC.22 analysis leveraging data from the CoreValve US High Risk and SURTAVI trials as well as a nonrandomized registry compared rates of structural valve deterioration (SVD) in TAVR vs. SAVR.
  • Presented by Dr. Michael Reardon, results indicated SVD was lower with TAVR than SAVR.
  • SVD was associated with a nearly 2-fold increase in risk of death or rehospitalization in the first 5 years following either procedure.

3. Complete Revascularization Reduces Event Risk, Angina Burden in STEMI

  • A prespecified analysis of the COMPLETE trial examined angina burden and QoL among patients in the study.
  • Both strategies were associated with improved angina-related QoL compared to baseline but results suggested a greater proportion of patients were free of angina in the complete revascularization group than in the CLO group at 3 years (84.3% vs 87.5%; ARD, 3.2% [95% CI, 0.7-5.7]; P=.013; NNT=13).
  • Dr. Deepak Bhatt provides further perspective in ACC.22 interview.

4. Don’t Miss a Beat ACC.22 Recap

  • In the ACC.22 Preview edition of Don’t Miss a Beat, Drs. Greene and Vaduganathan previewed SODIUM-HF, PROMPT-HF, DIAMOND, and SCORED.
  • In this recap, hosts provide their perspective on the results and applicability of data from the SODIUM-HF, PROMPT-HF, and DIAMOND trials.

5. MOSAIC Trial Supports Home-Based Walking Programs in Patients with PAD

  • A multicenter randomized clinical trial, MOSAIC randomized patients to a home-based exercise program vs usual care for improving walking scores in those with peripheral artery disease.
  • Results suggested participation in a home-based walking program was associated with a 16.5-meter adjusted difference in 6-minute walking distance after 3 months compared to usual care, but investigators pointed out this failed to exceed the threshold for a large clinically important difference.

6. Obesity, Age at Menopause Influence Heart Failure Risk

  • An NHLBI-funded analysis of the ARIC study sought to assess impact of obesity and age at menopause on heart failure risk among women.
  • Results of the 4500-person analysis indicate obesity was associated with increased risk of heart failure across all age groups, but this risk was most apparent among women with obesity who entered menopause at age of 55 years or later.

7. AHA Targets NAFLD in Scientific Statement

  • On April 14, the American Heart Association released a scientific statement with the intent of drawing awareness to and increasing emphasis on addressing NAFLD to reduce CVD risk.
  • An 18-page documented composed by a multidisciplinary team, the statement cites more than 160 reference documents.
  • Statement outlines pharmacological interventions and role of addressing modifiable risk factors in management and prevention of NAFLD.