The Curbsiders Internal Medicine Podcast #459 DIGEST: Finerenone for Heart Failure, PCV21 and the latest Pneumonia Vaccine Recs, 24-hour vs 15-hour Oxygen Therapy, and PREVENT vs PCE for Cardiovascular Risk Estimation
Oct 28, 2024
Dive into the latest innovations in heart failure treatment with finerenone, spotlighting its significant findings. Discover updates on pneumonia vaccination, especially the new PCV21, and its impact on risk for older adults. The discussion also covers long-term oxygen therapy strategies and their implications for patient care. Plus, explore critiques of outdated cardiovascular risk calculators and the introduction of the PREVENT equations for more tailored assessments. It's a jam-packed conversation that blends medical insights with a dash of humor!
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HFPEF Treatment Options
- Finerenone will likely enter guidelines, but its high cost may lead to more spironolactone or eplerenone use.
- These are cheaper alternatives, approximating the benefits of the non-steroidal MRA finerenone.
Shifting Pneumococcal Disease Burden
- Adults now have higher rates of invasive pneumococcal disease than children due to childhood vaccination programs.
- This shifted prevalent serotypes, necessitating new adult vaccines like PCV21.
Pneumococcal Vaccine Guidance
- Use the Numerex app for personalized pneumococcal vaccine recommendations, especially for patients in the Western US.
- Consider PCV20 or PCV15/13 for those with risk factors for serotype 4, particularly unstable housing.