Important work.. recognizing oral diuretic intensification as a meaningful worsening HF event could really improve how trials capture real-world risk and patient outcomes.
Harriette Van Spall MD MPH 🇨🇦
@hvanspall.bsky.social
Cardiologist, Clinical Trialist McMasterU. Heart failure, Cardiometabolic Disease, Implementation Science. Editor Circulation.
evidence.nejm.org/doi/full/10.... Worsening #HF requiring oral #diuretic intensification is clinically relevant, associated w ⬆️ ☠️ Here we review #RCT data, propose a standard definition for ODI, argue for its inclusion in primary outcome of HF RCTs, & show how this will ⬆️ trial efficiency
Oral Diuretic Intensification as a Worsening Heart Failure Event in the Primary Outcome of Clinical Trials
Although evidence-based therapies for patients with heart failure (HF) have decreased all-cause mortality, the residual risk of other clinically relevant outcomes — such as worsening HF — remains h...
evidence.nejm.org
Among patients with acute #HF in the #CLOROTIC #RCT 💠 #Diuretic resistance -> worse outcomes 💠 #Hydrochlorthiazide effect on weight loss was consistent across categories of diuretic resistance Trial led by JC Trullàs, subanalysis by A Pandey onlinelibrary.wiley.com/doi/10.1002/...
2026 #HeartDisease & #Stroke #Statistics: Report of US & Global Data From American Heart Association is here‼️ Did you know that the leading causes of #heartfailure are preventable? CAD (20%) HTN (20%) tobacco (14%) obesity (12%) diabetes (12%) www.ahajournals.org/doi/10.1161/...
Worsening heart failure is commonly managed w/oral diuretic intensification (ODI). In a new NEJM Evidence article, learn how the inclusion of ODI into trial endpoints could yield consistent treatment effect estimates & improve statistical efficiency. eviden.cc/48zIwEp @hvanspall.bsky.social
#Medtronic press release on our pivotal #ELEVATE-HFpEF RCT which will test the efficacy & safety of a personalized elevated #pacing rate (based on LVEF & height) in #HFpEF 75 countries 2 patients enrolled already (AUS & US) Methods to be presented at #HFSA25 news.medtronic.com/2025-09-15-M...
FDA announces approval for #semaglutide 2.4 mg sc weekly for #MASLD based on results of the #ESSENCE #RCT. Did you know that #CVD is the leading cause of death in patients with #MASLD? Common mechanisms & now, common treatments for #CKLM diseases www.novonordisk.com/news-and-med...
I love my outdoor #office, where work and play are fully intertwined! What does your #Saturday morning look like? #HappySeason #HomeSweetHome #JoyInWork
It’s impossible to uncouple #health from #economic policy Healthiest countries have fair economic policies that allow upward mobility & access to healthier lifestyles Focusing on individual interventions alone: inadequate www.thelancet.com/journals/lan...
Childhood obesity: prioritising a healthy start
Recent data from National Health Service (NHS) weight clinics in England show that a disproportionate number of referrals originate from the most deprived areas, with some children having BMIs over 40...
thelancet.com
Phase 3 Trial of #Semaglutide in #Metabolic Dysfunction–Associated #Steatohepatitis In patients with #MASH and moderate or advanced #liver #fibrosis, once-weekly semaglutide at a dose of 2.4 mg improved liver steatohepatitis & fibrosis at 72 weeks t.co/vfcgItgXpb
https://www.nejm.org/doi/full/10.1056/NEJMoa2413258
t.co
Regional disparities in participant #enrolment in RCTs are related to regional #disparities in site recruitment relative to 🌎disease distribution We propose estimating site representation index during trial planning to ensure globally (or nationally) representative #RCT popn doi.org/10.1002/ejhf...
#NUDGECKD #ERA25 LBT #KristofferSkaar & #TorBiering SimPub #Circulation Pragmatic 2x2 factorial #implementation RCT Randomization at cluster + individual level E-letters re #GDMT to 1540 GPs & 22617 patients w #CKD did not ⬆️ uptake of #RASi or #SGLT2i www.ahajournals.org/doi/10.1161/...
Huge Danish trial of nudges Patient level (N 22,000) + practice level (1500 practice cluster with N 28,000 pts) To increase RASination & Flozination www.ahajournals.org/doi/abs/10.1... in @ahajournals.bsky.social at #ERA25 Absolutely null effect - is the baseline too high to improve upon?
Pill splitting guide for patients who take a lot of pills... Which ones are safe to divide? myheartsisters.org/2016/12/04/p...
Pill splitting: which ones are safe to divide?
Don’t split your pills with a knife. Always use a pill-splitter. Don’t split them in advance – and other very sound tips for people like me who have been (until now!) using a kitchen kn…
myheartsisters.org
🚨 Missed early registration? No problem. You can still sign up for RISE @ ESC Congress 2025, the essential event for women in cardiology. 📍 Madrid | 🗓️ Aug 28 🎯 Leadership on the Global Stage Register now 👉 rise.womenasone.org #LetsRISE2025 #ESCCongress #WCCardio #CardioSky #WIC
Ship of #tolerance, created by 2000 school children in our town and displayed in #OakvilleGalleries #GairlochGardens Such a collaborative, moving art display, with ideas communicated in a way that only kids can do.
“The true north is indeed, strong and free” A balanced and appropriate speech from the throne on this historical day. Climate change and biodiversity were woven into this speech alongside, not mentioning by name he who shall not be named. m.youtube.com/watch?v=FCzk...
LIVE: King Charles presents the speech from the throne in Ottawa | CTV News Special Coverage
YouTube video by CTV News
m.youtube.com
Interplay of CKD & Effects of #Tirzepatide in Patients With #HFpEF & Obesity: SUMMIT Trial #CardioSky #NephroSky #JACC www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social @dlbhattmd.bsky.social @hmkyale.bsky.social @chriskramermd.bsky.social @psatishmd.bsky.social @drmonalidesai.bsky.social
Interplay of Chronic Kidney Disease and the Effects of Tirzepatide in Patients With Heart Failure, Preserved Ejection Fraction, and Obesity: The SUMMIT Trial
jacc.org
The sweetest word in the world, the one I’m most grateful to hear each day, is #mum. #MothersDay2025
Is #Aficamten Plus #Disopyramide More Effective Than Aficamten Alone in obstructive HCM? #CardioSky #JACCHF www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social @jimjanuzzi.bsky.social @robmentz.bsky.social @hvanspall.bsky.social @vietheartpa.bsky.social @load-dependent.bsky.social
While #health systems across🌎 are designed around #acute illnesses, 86% of yrs lived w disability & 71% yrs of life lost are from #chronic diseases Burden of chronic dz ⬆️ in higher income countries & w age How to move needle? See our analysis @Nature.bsky.social rdcu.be/ek1MH
📢 #CardioSky #MedSky #NephSky join us👇for our @ahascience.bsky.social #HTNImpact webinar! 🌟Faculty @jordybc.bsky.social @daichishimbo.bsky.social + more provide insights on #BP Timely @amjhypertension.bsky.social State of Art Review #AI to improve #BP Control academic.oup.com/ajh/article-ab…
#May is #BloodPressure Awareness Please join me & @ahascience.bsky.social #Hyperetension #Digital Strategy Eds @carmendemigue12.bsky.social & Guto Montezano #HTNImpact webinar ⏬with🌟Faculty @jordybc.bsky.social @daichishimbo.bsky.social Lara Kovell & Pierre Paradis Register▶️ ahajrnls.org/3RGLjlT
Today, we voted to protect our #sovereignty, freedom, environment, economy, people, We voted for knowledge, alliances, respect, strength, unity We voted to care about those with less so that every kid has a chance to build #CanadaStrong #ViveLeCanada #April2025
Canadians go to #polls today Counting on us to elect a strategic, steady leader who will protect #Canada’s - sovereignty - environment - economy - education - healthcare - global alliances Counting on us to reject politics of anger, fear, division #TrueNorth #CanadaStrong
Happy #AdministrativeProfessionalsDay, dear Robin Thank you making magic happen in my professional life & in our program every day Thank you for being a caring friend in the truest sense of the word Thank you for being incredibly kind to our patients I’m so #grateful for you
#ClimateChange threatens health and livelihood, commonly displacing people. Children are among the most vulnerable. www.unicef.org/stories/3-wa...
3 ways climate change threatens children's lives
Climate change poses significant risks to children’s health and well-being
unicef.org