Top Tweets for #RALES
En #Villaviciosa despedimos #Septiembre2024 por todo lo alto!! 🎉🪅 Fiestas en #Grases, #Rales, Feria de los Figos en #Rozaes y Exposición de Huerta y Planta en #Quintes #ComarcadelaSidra #Asturias
#MRAs in heart failure: an individual patient level meta-analysis
👥13,846 patients analyzed across 4 major HF trials ;
#RALES (spironolactone)
#EMPHASIS-HF (eplerenone)
#TOPCAT (spironolactone)
#FINEARTS-HF (finerenone)
📍MRAs ⬇️ risk of CV death or HF hospitalization by 23% (HR 0.77, 95% CI 0.72–0.83).
📍Greater efficacy in HFrEF: CV death or HF hospitalization reduced by 34% (HR 0.66).
📍Moderate benefit in HFmrEF/HFpEF: Risk reduced by 13% (HR 0.87).
📍All-cause death reduced in HFrEF (HR 0.73) but not in HFmrEF/HFpEF.
📝Steroidal MRAs ⬇️ the risk of CV ☠️ or HF 🏥 in patients with #HFrEF and nsMRAs ⬇️ this risk in patients with #HFmrEF or #HFpEF. 🏆
https://t.co/M0bmQxnYC2 @TheLancet #ESCCongress
@PSJhund @mvaduganathan @scottdsolomon @ShelleyZieroth @lamcardio @FaiezZANNAD @HFpEF
#MRAs in heart failure: an individual patient level meta-analysis
👥13,846 patients analyzed across 4 major HF trials ;
#RALES (spironolactone)
#EMPHASIS-HF (eplerenone)
#TOPCAT (spironolactone)
#FINEARTS-HF (finerenone)
📍MRAs ⬇️ risk of CV death or HF hospitalization by 23% (HR 0.77, 95% CI 0.72–0.83).
📍Greater efficacy in HFrEF: CV death or HF hospitalization reduced by 34% (HR 0.66).
📍Moderate benefit in HFmrEF/HFpEF: Risk reduced by 13% (HR 0.87).
📍All-cause death reduced in HFrEF (HR 0.73) but not in HFmrEF/HFpEF.
📝Steroidal MRAs ⬇️ the risk of CV ☠️ or HF 🏥 in patients with #HFrEF and nsMRAs ⬇️ this risk in patients with #HFmrEF or #HFpEF. 🏆
https://t.co/M0bmQxnYC2 @TheLancet #ESCCongress
@PSJhund @mvaduganathan @scottdsolomon @ShelleyZieroth @lamcardio @FaiezZANNAD @HFpEF
And we are live with this newest video at https://t.co/XQjYltP5PB! We discuss the answer with a focus on a clinical trial that will soon have its 25th birthday! All in 10 minutes flat! #RALES
So is it??? Had a lot of fun discussing pharmacology with practical application in this soon to be released video for our @teachmepharm family. #meded #teachmepharm #pa #np #md #do #rn #rph #pharmd
Important study from #RALES / #EMPHASIS:
Decline in eGFR to <30 on MRA should *not* cause discontinuation ‼️the effect on clinical outcomes is still present (and impressive: HR 0.61 for mortality)
@JACCJournals @UoGHeartFailure @mvaduganathan
https://t.co/Xt3QQkLj80
Cielo despejado desde #SantaEugenia #Santoxenia mirando a #Rales que hoy celebra sus fiestas de los #SantosMartires #Villaviciosa @eltiempotpa
😅Se nos presenta un #findesemana a tope!
Más info: https://t.co/3RD4iR0JcZ #Villaviciosa #ComarcadelaSidra #Asturias #Rales #Grases #Quintes
Sábado 9:00 de la mañana desde #SantaEugenia con vistas de #Rales al fondo. #Villaviciosa #Asturias @eltiempotpa
Ruth & Norman Rales Jewish Family Services: Remembering Norman R. Rales 1923-2012 No Holocaust biography here? #NormanRales Steve & Mitchell #Rales @RealGeorgeWebb1 @DavidCranmerUn1 https://t.co/80bhov9VPg
11b) Adding #spironolactone to the standard of care #SOC among patients with severe #HF improved survival & reduced morbidity in the landmark Randomized Aldactone Evaluation Study (#RALES) trial
🔓 https://t.co/qxthDESvEh
11b) Adding #spironolactone to the standard of care #SOC among patients with severe #HF improved survival & reduced morbidity in the landmark Randomized Aldactone Evaluation Study (#RALES) trial
🔓 https://t.co/1qHpveAtgM
Let’s get to the results!
1,078 patients randomized
77% white, 61% 👨
68%: LVEF ≤40%
48%: ischemic cardiomyopathy
Baseline med use:
39% ACE
17% ARB
8% ARNI
36% BB
95% MRA
Does this represent your patient population? #CardsJC
After 1.473 votes 🗳️ & interesting debate, these are my take-home messages:
🔸Spiro must be present at "something" dose at #HFrEF
🔸#ESC guidelines should established as target dose not only 50mg od. but also 25mg od. (#RALES data)
🔸25mg od is fine is you struggle with ⬆️K+
Based on research evidence, what should be the target dose of spironolactone in #HFrEF?
#CardioTwitter #CardioEd #MedEd #HeartFailure
@SeguraCardio @AndrewJSauer Guidelines reflect #RALES trial protocol. Many achieved 50mg in the RCT.
No dose-ranging studies on clinical outcomes have been performed of low vs. high dose MRAs in HF, but there is a clear dose relationship between MRA dose and natriuretic peptide reduction w higher doses.
Seguimos con las últimas fiestas de septiembre en #villaviciosa 💃🕺
Os esperamos en #rales #grases o #quintes
@mvaduganathan @VerwerftJan @drjohnm @gcfmd Exactly. HFpEF population is also not an ‘ideal’ population given the mixed bag of phenotypes. What about #SENIORS in elderly, #RALES in patients with severe symptoms and #SOLOIST-WHF, #VICTORIA and #EMPULSE in patients with (recently) worsening HF. Evidence in high risk pats.
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