Javed Butler, Ileana Piña, and Patrick Rossignol talk about strategies for maintaining optimal GDMT while lowering potassium in patients with HF and hyperkalemia.

ACC.23 Amrita Mukhopadhyay discusses the BETTER CARE-HF study, which investigated whether an alert or an inbox message delivered via EHR systems to cardiologists, improves prescribing of MRA in patients with HFrEF compared to usual care.

Patients with HF may experience a transient decline in eGFR of up to 15-20% after initiation of sacubitril/valsartan. But how does this affect treatment effects? This post hoc analysis of the PARADIGM-HF and PARAGON-HF study offers more insight.

In this prespecified analysis of the DELIVER trial, the authors evaluated whether baseline kidney function modified the effect of the SGLT2i dapagliflozin on CV improvement in patients with HFmrEF or HFpEF, and determined the effect of dapagliflozin treatment on kidney outcomes.

ACC.23 Dapagliflozin reduced pulmonary capillary wedge pressure at rest and during exercise and body weight, amongst others, in HFpEF patients compared with placebo, as shown by the CAMEO-DAPA trial.

ACC.23 In 29 HFpEF patients with chronotropic incompetence, rate-adaptive atrial pacing did not improve exercise performance or health status. In addition, pacemaker implantation was associated with more adverse events.

ACC.23 "Early treatment-related eGFR decline should not stall uptitration or impede continuation of ARNI", says Safia Chatur. She lists the findings of an analysis of PARADIGM-HF and PARAGON-HF in patients with HF.

ACC.23 An EHR-embedded and selective alert delivered during the clinical encounter increased the likelihood of prescribing MRA by 2.5x in MRA-eligible HFrEF patients in an outpatient cardiology setting.

ACC.23 The REVIVED analyses showed that PCI did not improve prognosis or LV recovery in patients with extensive CAD compared with optimal medical therapy alone, regardless of viability characteristics at baseline.

ACC.23 Treatment with anthracyclines may lead to cardiotoxicity. The STOP-CA trial investigated the effect of statins compared to placebo on cardiac dysfunction in patients with lymphoma treated with anthracyclines.

"You can't discount the possibility of revascularization via PCI or surgery in a patient with ischemic cardiomyopathy regardless of what their starting point is", says Lauren Barron. Together with Navin Kapur and Adam DeVore, she discusses revascularization in high-risk surgical patients.

Navin Kapur, Adam DeVore and Lauren Barron discuss the use of mechanical circulatory support for revascularization in high-risk or complex PCI in patients with heart failure and multivessel disease.