Cardionerds: A Cardiology Podcast 408. Journal Club: The SUMMIT Trial with Dr. Milton Packer
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Jan 21, 2025 Milton Packer, a pioneer in heart failure research with over 500 publications, joins the discussion on the groundbreaking SUMMIT trial. The trial investigated tirzepatide's impact on obese heart failure patients, revealing reduced risks of cardiovascular death and enhanced quality of life. The conversation covers key insights from recent trials, the effectiveness of managing heart failure alongside obesity, and the collaboration between academia and industry in medical research. Packer sheds light on the trial's strengths, limitations, and the need for further exploration in weight management.
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Obesity and HFpEF Overlap
- Obesity and HFpEF significantly overlap, with 60-70% of HFpEF patients having a BMI > 30.
- Visceral adiposity, measured by waist-to-hip ratio, is a key factor in this overlap.
Natriuretic Peptides in Obesity-Related HFpEF
- Natriuretic peptides are not typically high in HFpEF.
- Obesity further suppresses these peptides, potentially masking their elevation.
Endpoint Shift in SUMMIT Trial
- The SUMMIT trial shifted primary endpoints after the STEP-HFpEF trial results.
- STEP-HFpEF revealed a larger-than-expected impact of semaglutide on worsening heart failure events.