Thx for sharing! For ADHF patients on floors do we really push the afterload reduction acutely IRL ? I feel it’s focus on loop diuretics and d/c with focus on outpt titration of meds. It’s those cold unit patients that really benefit from vasodilation. I just a PCI guy though!
-
-
-
This might be a bit provocative but perhaps we focus too much on hemodynamic measures that might not drive outcomes as HF is far more complicated- we need patients to be on evidence based Rx like ARNI/SGLT2i/Etc. not "trying to get SVR down".
Kraj razgovora
Novi razgovor -
-
-
Afterload reduction would be effective in patients with a low output state and vasoconstriction. I don’t think the trial addresses this question in the right patient population.
-
What defines afterload reduction? How much do the means matter- ACE-I vs NP vs IABP? If truly low output should these patients be discharged on meds or get eval for VAD and transplant?
Kraj razgovora
Novi razgovor -
-
-
This was presented at
#ESCCongress and got a fair amount of tweets in
my main critique: wants to be both an acute HF trial and a drug up-titration trial -
What was your take home?
- Još 4 druga odgovora
Novi razgovor -
-
-
The consistent focus of OPTIMIZE-HF and GWTG-HF since 2003-present has been initiation, continuation, and optimization of GDMT for patients hospitalized with HF. For HFrEF that consists of ARNI, BB, MRA, and SGLT2i, with loop diuretics as needed.
@NMHheartdoc@JavedButler1 -
Surprisingly (for me) little furosemide needed in the first days in these AHF patients.pic.twitter.com/hPmXBep39C
Kraj razgovora
Novi razgovor -
-
-
Couple of unusual aspects to this trial: 1) Nearly 1/3 had HFpEF -- not sure acute vasodilation and rapid RASi up-titration should be expected to improve survival and rehospitalization since these benefits are barely present in chronic HFpEF trials.
-
2) Initial therapy was *transdermal* nitrate. Perhaps that's more common elsewhere, but this was the first I'd ever seen it. Seems like dose-response would have been easier to capture with IV nitroglycerin.
Kraj razgovora
Novi razgovor -
Čini se da učitavanje traje već neko vrijeme.
Twitter je možda preopterećen ili ima kratkotrajnih poteškoća u radu. Pokušajte ponovno ili potražite dodatne informacije u odjeljku Status Twittera.