Publication highlights- 10th to 15th April 2023

1. Statins may help prevent anthracycline cardiotoxicity in chemotherapy

300 patients (median age 52 years, 47% female) with lymphoma undergoing treatment with anthracyclines at a median dose of 300 mg/m2 were enrolled. Half of the participants were randomized to take #atorvastatin (40 mg) and half to take a placebo daily, starting before their first dose of anthracyclines and continuing for 12 months. Researchers defined the primary endpoint as the proportion in each group who had a decline in #LVEF of ≥10% to an EF <55%. The primary endpoint at 12 months occurred in 9% of the atorvastatin group and 22% in the placebo group (p=0.002). A secondary outcome concerning the proportion in each group who had a decline in LVEF of ≥5% to an EF <55% was seen in 13% in the #atorvastatin group and 29% in the placebo group (p=0.001)

2. First oral Treatment Approved for Anemia Caused by CKD

The U.S. Food and Drug Administration approved #daprodustat as the first oral treatment for anemia (decreased number of red blood cells) caused by chronic kidney disease for adults who have been receiving dialysis for at least four months. Daprodustat is not approved for patients who are not on #dialysis .?

The effectiveness of daprodustat was established in a randomized study of 2,964 adults receiving dialysis. In this study, adults received either oral daprodustat or injected recombinant human erythropoietin (a standard of care treatment for patients with anemia due to chronic kidney disease). Daprodustat increased and maintained the hemoglobin within the target range of 10-11 grams/deciliter, similar to that of the recombinant human #erythropoietin .

3. Sacubitril/Valsartan Likely to Improve Pre-HFpEF Outcomes vs Valsartan Alone: The PARABLE Randomized Clinical Trial

The 250-patient study cohort comprised individuals who were asymptomatic for #heartfailure at screening for this analysis but had #hypertension or #diabetes , B-type natriuretic peptide (BNP) between 20 and 280 pg/mL or N-terminal pro-b-type natriuretic peptide (#pro -BNP) between 100 and 1000 pg/mL, enlarged transthoracic left atrial volume index above 28 mL/m2, and preserved ejection fraction greater than 50%. Randomization was to #sacubitril /valsartan titrated to 200 mg twice daily or #valsartan titrated to 160 mg twice daily. The main outcome measures were left atrial volume index, left ventricular end-diastolic volume index, ambulatory pulse pressure, N-terminal pro-BNP, and adverse CV events.

#Sacubitril /valsartan vs valsartan was associated with a reduction in blood pressure, pulse pressure, and N-terminal pro-b-type natriuretic peptide; an increase in maximal left atrial volume index measured by cardiac magnetic resonance imaging despite lower filling pressures; less decline in kidney function; and fewer serious adverse cardiovascular events. These findings could reflect improved cardiac and vascular compliance or adverse cardiac remodeling.

4. Addition of topical sucralfate?to mupirocin has no benefits in terms of healing rates in diabetic foot ulcer treatment

This open-labeled randomized study was conducted on 108 patients to evaluate the effectiveness of topical #sucralfate and #mupirocin combination, compared to topical mupirocin alone.?The mean±SD of the healing rates in the sucralfate group and the control?group?were estimated to be 16.2±7.3% and 14.5±6.6%, respectively, and comparison of the means by Student's t-test failed to show a statistical difference in healing rates between the two groups (p=0.201).

5. Elevated Heart Rate May Be Associated With Increased Risk of type 2 #diabetes (T2D)

The study included 7630 participants (mean age 63.7 years, 58% women) from the population-based Rotterdam Study who had no history of #T2D and atrial fibrillation at baseline. During a median follow-up of 8.6 years, 871 individuals developed incident T2D. One standard deviation (SD) increase in heart rate were independently associated with incident T2D. High #heartrate and heart rate variability were significantly associated with an increased risk of developing T2D, especially among younger individuals. The HRs were 1.54 (95% CI 1.08-2.06) for participants younger than 62 years and 1.15 (95% CI 1.01-1.31) for those older than 62 years for heart rate (p?for interaction <0.001).?

6. Clopidogrel linked to better long-term outcomes than aspirin in PCI patients with and without diabetes: A Post Hoc Analysis of the HOST-EXAM Trial

This was a post hoc analysis of the HOST-EXAM randomized clinical trial, an investigator-initiated, prospective, randomized, open-label, multicenter trial performed at 37 centers in Korea. 5438?patients who received dual antiplatelet therapy without clinical events for 6 to 18 months after percutaneous coronary intervention with drug-eluting stents were evaluated. The main outcome was primary composite end point of all-cause death, nonfatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and major bleeding at 24-month follow-up. The rate of the primary composite endpoint was significantly lower in the #clopidogrel group compared to the #aspirin group in patients with diabetes and without diabetes. The presence of diabetes was not associated with a difference in benefit observed with clopidogrel monotherapy over aspirin for the thrombotic composite endpoint.

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