What is current guideline-recommended medical therapy for #HFrEF? #ESCCongress @escardio

Meta-analysis of digitalis glycosides in HFmrEF or HFrEF indicated reduced risk of worsening #HeartFailure events, with no difference in mortality, across multiple randomized trials. ja.ma/3SpvLq4

Blood #aldosterone concentrations and effects of #MRA in #HeartFailure Pooled analysis of 1,019 HF patients (DOSE, CARRESS-HF, MDR, #TOPCAT) showed #MRA benefit was dependent on baseline aldosterone: high aldosterone predicted improved outcomes (HR 0.63), while low aldosterone was associated with worse outcomes (HR 1.66 academic.oup.com/eurheartj/a… #EHJ @ESC_Journals @markcpetrie20 @ehj_ed @EJHFEiC @MarcoMetra

We know the rSS is an independent predictor of adverse CV events & survival, but what is the role of complete revasc in elderly patients? We did a complex PCI of an LAD CTO where laser atherectomy wasn’t sufficient & a 1.25 bur was necessary.. MCS? Single access? @EuroInterventio 📚eurointervention.pcronline.c… @NEJM SENIOR RITA @VijayKunadian 📚nejm.org/doi/full/10.1056/NE… FIRE @SimoneBiscaglia 📚 nejm.org/doi/full/10.1056/NE…

A new definition of #MINOCA: from infarction to #injury #EHJ @chiarabd @TomLuscher @ehj_ed @ESC_Journals academic.oup.com/eurheartj/a…

@purviparwani @HanCardiomd @DrMarthaGulati @SABOURETCardio

Reframing #HFpEF Through the Cardio–Hepato–Pancreas Inflammatory Axis @EMJReviews #HLPAxis emjreviews.com/flagship-jour…

Bridging the gap: adapting heart failure guidelines for resource-limited settings: A European Journal of Heart Failure expert consensus document #EJHF @AmrAbdin10 @GianluSava @HanCardiomd @GiuseppeGalati_ academic.oup.com/eurjhf/adva…

📢 Upcoming #HFA_ESC Journal Club HF Hospitalisation as an Endpoint in Trials: The Holy Grail? HF hospitalisations are among the most commonly used endpoints in contemporary HF trials. But how well do they reflect mortality risk & meaningful treatment benefit? Join us for an engaging discussion on the strengths, limitations, & future of HF hospitalisation endpoints with the outstanding faculty: Prof. @GianluSava, Drs. @j_sokolska, @DrSamStraw, & @GTersalvi 🗓️ Thursday, 18 June 2026 🕕 18:00-19:00 CEST Register now🔗: esc365.escardio.org/event/26… #HFAYoung @escardio @MarcoMetra @WilfriedMullens @jozinetm @h_arfsten

In critically ill patients with metabolic acidosis requiring vasopressor support, sodium bicarbonate therapy did not reduce the incidence of MAKE within 30 days compared with placebo nejm.org/doi/full/10.1056/NE… @NEJM

AstraZeneca’s Baxfendy (#baxdrostat) has been approved in the US as a first-in-class aldosterone synthase inhibitor (#ASI) for the treatment of HTN in combination with other antihypertensive medications astrazeneca.com/media-centre… @AstraZenecaUS

Iron deficiency in #HFpEF: a true clinical divergence or a competing risk artefact academic.oup.com/eurjhf/adva… @ESC_Journals #EJHF

#AMI vs acute decompensated #HeartFailure in cardiogenic shock: a systematic review and meta-analysis of clinical phenotypes and mortality academic.oup.com/eurjhf/adva… @EJHFEiC @ESC_Journals @cardioceptor @MarcoMetra

Palantir software halves sepsis deaths at US hospital The Sepsis Hub, developed with Tampa General Hospital in Florida, detects subtle changes in vital signs so antibiotics are given early thetimes.com/uk/healthcare/a…

A Florida hospital is using Palantir to catch sepsis earlier, it's saved 866 lives so far techspot.com/news/112709-pal…

ARISE-FLUIDS has arrived and it's awesome 🥳 For over a decade, the Surviving Sepsis Guidelines recommended that septic patients get at least 30 cc/kg fluid. In the United States, these guidelines were weaponized into performance metrics, pressuring clinicians to prescribe arbitrary volumes to every patient. Evidence-based clinicians have LONG known that this guideline lacked evidentiary support. For example, I've attached a picture of a blog I wrote about this back in 2017. Despite the lack of evidentiary support and some evidence of harm, the Surviving Sepsis Guidelines INSISTED on perpetually recommending 30 cc/kg fluid resuscitation. We finally have a prospective RCT demonstrating that mandating early administration of 30 cc/kg fluid (as compared to early vasopressors) doesn't help and may actually cause harm. It's important to note that all of the hard endpoints in this trial were neutral (e.g., mortality, days free of organ support). I still think that 30 cc/kg fluid is a pretty reasonable volume of fluid for *most* patients. But the study does suggest that giving too much fluid may promote edema - so we should be *thoughtful* about this intervention rather than mandating it for every septic patient. Based on the subgroup analysis, the fluid-conservative strategy may have helped the subgroup of pneumonia patients the most. This is statistically nonsignificant but aligns with my expectation. ARDSy patients often don't respond well to fluid. (In contrast, I really doubt that a liter of fluids in either direction matters for most urosepsis patients.) This is a great example of the over-reach of guidelines and protocoled medicine. People get all upset about practice variation, so sometimes they try to stomp it out using guidelines and protocols. But these guidelines are highly fallible, so what may occur is that you standardize care in a way that harms everyone equally. 🤦‍♂️

CLINCAL COMMENTARIES: Should beta-blockers be withheld after myocardial infarction? John Cleland, Ben Hurdus, & Chris Gale explore recent trial results, including what this tell us about the practice of evidence-based medicine academic.oup.com/cardiovascr… #CardiovascularResearch

Use of Predicted Risk and Expected Benefit to Guide Decision-Making in #CKD Syndrome for the Primary Prevention of CVD: A Scientific Statement From the @AHAScience and @ACCinTouch ahajournals.org/doi/10.1161/… @CircAHA

2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of CKM Syndrome: A Report of the @ACCinTouch /@AHAScience Joint Committee on Clinical Practice Guidelines ahajournals.org/doi/10.1161/… @AHAScience @CircAHA