Name:
New Approach to Heart Failure Treatment
Description:
New Approach to Heart Failure Treatment
Thumbnail URL:
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Duration:
T00H03M27S
Embed URL:
https://stream.cadmore.media/player/f0833c31-fd81-4880-b877-f085f8aea461
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/f0833c31-fd81-4880-b877-f085f8aea461/18778982.mp3?sv=2019-02-02&sr=c&sig=xZ%2FKAAqw4XM4el9tZbOSjOWuoAztJgugAIOBwUfGNVQ%3D&st=2024-12-21T14%3A27%3A09Z&se=2024-12-21T16%3A32%3A09Z&sp=r
Upload Date:
2022-02-28T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
>> Practice Impact Extra podcasts are derived from Hurst's, The Heart Board Review, and other online resources available only through accesscardiology.com. >> Despite the broad use of newer agents and guideline recommendations for the treatment of heart failure, the prognosis for heart failure still remains poor. Therefore, there really is a need for new approaches for the treatment of heart failure. [ Music ] Hi, I'm Dr. Bernie, and welcome to Practice Impact Extra.
A new and novel drug, omecamtiv mecarbil, is a selective cardiac myosin activator that improves cardiac contractility. Is this an agent that can be added to the list of new heart therapies for patients with heart failure with reduced ejection fraction? The GALACTIC Heart Failure trial published in the New England Journal of Medicine in November 2020 set out to evaluate omecamtiv compared to placebo among patients with heart failure with a reduced ejection fraction.
This study randomized a little over 4,000 patients with heart failure and reduced ejection fraction to either omecamtiv versus about 4,000 patients who were randomized to placebo. Patients' medial injection fraction was 27%. They were symptomatic with New York Heart Classification II, III, or IV. The patient did have a good background in medical treatment that included ACE and ARBs, ARNI, beta blockers, mineralocorticoid antagonists, as well as SGLT-2.
The follow-up period was 21.8 months. So what were the primary import results? Cardiovascular death or heart failure event at 21 months occurred 37% in the omecamtiv group compared to 30% in the placebo group. When you look into the subanalysis as they did, they noted a greater treatment effect in patients with ejection fractions of 27% or less, as opposed to those with a higher ejection fraction.
However, omecamtiv did not offer any benefit as it relates to cardiovascular death or was there an improvement in the health status questionnaire. From a safety standpoint, omecamtiv did appear safe with similar rates of cardiac ischemia, as well as ventricular arrhythmias in both groups. So what's my take? The GALACTIC Heart Failure outcome data was not particularly encouraging to me. The benefit was very small, but I was encouraged by the signal of greater treatment effects in patients with ejection fraction of less than 27%.
My feeling is if this agent is FDA approved, it may have limited implementation in clinical practice. Thank you for joining me and see you next time on Practice Impact Extra. >> We hope you enjoyed this podcast from McGraw-Hill. Subscribers to AccessCardiology have instant access to over 25,000 pages of rich medical content, receive medical updates from trusted experts, and have access to other special features. To subscribe or learn more, please visit accesscardiology.com.
