We have this whole history of showing that as ejection fraction goes up, the benefit is less. Now, if empagliflozin in EMPEROR-Preserved was the first trial ever done, I think that trend that you're talking about in the primary end point with ejection fraction, we probably would have ignored it by saying that, “Oh, it's just noise with little interaction, the P value is completely nonsignificant, and there is nothing there.” Except we don't have these results in isolation. And also there was a significant sex interaction: that women tended to benefit more, and benefit to a higher ejection fraction level, than men, who benefited less and at a lower ejection fraction. One is that most of the other drugs have shown benefit in ejection fraction 55% or less. What we have learned in the previous trials of HFpEF are a couple of things. I don't think we can ignore all the previous trials, and we have to look at the new evidence in the light of all the previous trials. There was a clinically meaningful and statistically significant 21% reduction in the combined primary end point, making this trial the first to show benefit for patients with heart failure with reduced ejection fraction-for which targeted treatments have been hard to pin down.Ĭan you explain the difference in empagliflozin effectiveness for ejection fractions above 50%? And I believe these things work in concert, noted Javed Butler, MD, MPH, MBA, chairman for the Department of Medicine at the University of Mississippi, in an interview for ESC Congress 2021, this year's virtual meeting of the European Society of Cardiology.īutler, a co-lead investigator of the EMPEROR-Preserved trial presented at the ESC Congress, said the study aimed to address 3 questions: (1) time to cardiovascular death and heart failure hospitalization (2) total heart failure hospitalization, first and recurrent and (3) renal function preservation in terms of eGFR (estimated glomerular filtration rates). I have practiced meditation for over 30 years and continue to teach meditation in my free time.Whatever your theory of heart failure with preserved ejection fraction (HFpEF) is-the physiology is really complex-sodium glucose co-transporter 2 (SGLT2) inhibitors seem to be attacking every one of those. My wife and I have shared a common interest in meditation. I have two boys who like to travel and learn about new places and cultures. I enjoy spending my free time with my family. Early detection will hopefully lead to early modification of cardiac risk factors by lifestyle modification and intensive medical therapy, to lower the risk of progression to unfortunate events such as heart attacks and strokes that are the leading cause of death and disability in our nation. I have a special interest in early detection of coronary and cerebrovascular disease using advanced imaging techniques such as CT coronary calcium scoring, CT coronary angiography, nuclear stress testing, echocardiography and carotid artery ultrasound. I am fellowship trained and board certified in cardiovascular medicine, interventional cardiology and nuclear cardiology. I have been active in cardiac research and served as an investigator in several clinical trials that helped bring in cutting-edge technologies to my patients. Luke’s University Health Network, I practiced cardiology in Tupelo, Mississippi where I had the privilege of performing coronary, vascular and carotid artery interventions for over 14 years. I developed a keen interest in cardiology and went on to do a fellowship in cardiovascular medicine followed by further specialization in interventional cardiology and endovascular intervention. I did my residency in internal medicine followed by a year as chief resident in Brooklyn, NY. I practice cardiology with honesty and integrity. I am a good listener and I treat all my patients as I would treat a family member, and as I would like to be treated, if I were in their shoes. Luke’s provides me with a unique opportunity to continue to practice state of the art cardiology as well as be active in teaching in an academic environment and do my small part to help train the future generation of physicians. I enjoy teaching and sharing what I have learnt over the years with students and medical trainees. I am honored to be a part of the cardiology program at St.
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