Int J Angiol
DOI: 10.1055/a-2624-5735
Review Article

Pivotal Trials in Heart Failure in 2024—Putting Evidence into Clinical Practice!

1   Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
,
1   Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Suresh Kumar Behera
2   Department of Cardiology, Siksha 'O' Anusandhan, Institute of Medical Sciences & SUM Hospital, Bhubaneswar, Odisha, India
› Author Affiliations

Abstract

The intricate interplay of physiological, psychological, and social factors presents considerable challenges in addressing heart failure. It is imperative to comprehend the epidemiology and pathophysiology, identify predictors and their influence on clinical outcomes, and effectively utilize the diagnostic tools. Such evidence is vital for formulating innovative therapeutic strategies to decelerate the growing heart failure epidemic. As of 2024, the field of heart failure has witnessed significant advancements in therapies applicable to both heart failure with preserved and reduced ejection fraction. Recent studies in this domain yielded valuable insights into the latest developments in cardiovascular medicine, which possess the potential to revolutionize treatment strategies. These advancements advocate for a more integrated approach to patient care and aim to enhance overall clinical outcomes. Below is a concise overview of key studies showcased at scientific meetings over the past year, which promise to improve heart failure management.



Publication History

Article published online:
01 July 2025

© 2025. International College of Angiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Redfield MM. Heart failure—an epidemic of uncertain proportions. N Engl J Med 2002; 347 (18) 1442-1444
  • 2 Yan T, Zhu S, Yin X. et al. Burden, trends, and inequalities of heart failure globally, 1990 to 2019: a secondary analysis based on the global burden of disease 2019 study. J Am Heart Assoc 2023; 12 (06) e027852
  • 3 Giamouzis G, Kalogeropoulos A, Georgiopoulou V. et al. Hospitalization epidemic in patients with heart failure: risk factors, risk prediction, knowledge gaps, and future directions. J Card Fail 2011; 17 (01) 54-75
  • 4 Taylor CJ, Ordóñez-Mena JM, Jones NR. et al. National trends in heart failure mortality in men and women, United Kingdom, 2000-2017. Eur J Heart Fail 2021; 23 (01) 3-12
  • 5 Drozd M, Relton SD, Walker AMN. et al. Association of heart failure and its comorbidities with loss of life expectancy. Heart 2021; 107 (17) 1417-1421
  • 6 Rodés-Cabau J, Lindenfeld J, Abraham WT. et al. Interatrial shunt therapy in advanced heart failure: outcomes from the open-label cohort of the RELIEVE-HF trial. Eur J Heart Fail 2024; 26 (04) 1078-1089
  • 7 Hasenfuß G, Hayward C, Burkhoff D. et al; REDUCE LAP-HF study investigators. A transcatheter intracardiac shunt device for heart failure with preserved ejection fraction (REDUCE LAP-HF): a multicentre, open-label, single-arm, phase 1 trial. Lancet 2016; 387 (10025): 1298-1304
  • 8 Shah SJ, Borlaug BA, Chung ES. et al; REDUCE LAP-HF II investigators. Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial. Lancet 2022; 399 (10330): 1130-1140
  • 9 Melendo-Viu M, Abu-Assi E, Manzano-Fernández S. et al. Incidence, prognosis and predictors of heart failure after acute myocardial infarction. REC: Cardio Clinics. 2020; 55 (01) 8-14
  • 10 Harrington J, Jones WS, Udell JA. et al. Acute decompensated heart failure in the setting of acute coronary syndrome. JACC Heart Fail 2022; 10 (06) 404-414
  • 11 Usman MS, Siddiqi TJ, Anker SD. et al. Effect of SGLT2 inhibitors on cardiovascular outcomes across various patient populations. J Am Coll Cardiol 2023; 81 (25) 2377-2387
  • 12 Butler J, Jones WS, Udell JA. et al. Empagliflozin after acute myocardial infarction. N Engl J Med 2024; 390 (16) 1455-1466
  • 13 James S, Erlinge D, Storey RF. et al. Dapagliflozin in myocardial infarction without diabetes or heart failure. NEJM Evid 2024; 3 (02) EVIDoa2300286
  • 14 von Lewinski D, Kolesnik E, Tripolt NJ. et al. Empagliflozin in acute myocardial infarction: the EMMY trial. Eur Heart J 2022; 43 (41) 4421-4432
  • 15 Kosiborod MN, Abildstrøm SZ, Borlaug BA. et al; STEP-HFpEF Trial Committees and Investigators. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med 2023; 389 (12) 1069-1084
  • 16 Wilding JPH, Batterham RL, Calanna S. et al; STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med 2021; 384 (11) 989-1002
  • 17 Kosiborod MN, Bhatta M, Davies M. et al. Semaglutide improves cardiometabolic risk factors in adults with overweight or obesity: STEP 1 and 4 exploratory analyses. Diabetes Obes Metab 2023; 25 (02) 468-478
  • 18 Kosiborod MN, Petrie MC, Borlaug BA. et al; STEP-HFpEF DM Trial Committees and Investigators. Semaglutide in patients with obesity-related heart failure and type 2 diabetes. N Engl J Med 2024; 390 (15) 1394-1407
  • 19 Sherrid MV. Drug therapy for hypertrophic cardiomyopathy: physiology and practice. Curr Cardiol Rev 2016; 12 (01) 52-65
  • 20 Nagueh SF, Ommen SR, Lakkis NM. et al. Comparison of ethanol septal reduction therapy with surgical myectomy for the treatment of hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol 2001; 38 (06) 1701-1706
  • 21 Olivotto I, Oreziak A, Barriales-Villa R. et al; EXPLORER-HCM study investigators. Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2020; 396 (10253): 759-769
  • 22 Maron MS, Rowin EJ, Olivotto I. et al. Contemporary natural history and management of nonobstructive hypertrophic cardiomyopathy. J Am Coll Cardiol 2016; 67 (12) 1399-1409
  • 23 Crilley JG, Boehm EA, Blair E. et al. Hypertrophic cardiomyopathy due to sarcomeric gene mutations is characterized by impaired energy metabolism irrespective of the degree of hypertrophy. J Am Coll Cardiol 2003; 41 (10) 1776-1782
  • 24 Chamberlin P, Barrett L, Buckley N. et al. Phase 1 safety and tolerability study of IMB-1018972, a novel oral modulator of myocardial substrate utilization designed to improve cardiac metabolic efficiency and bioenergetics. J Am Coll Cardiol 2021; 77 (18, suppl 1): 180
  • 25 Maron MS, Mahmod M, Abd Samat AH. et al. Safety and efficacy of metabolic modulation with ninerafaxstat in patients with nonobstructive hypertrophic cardiomyopathy. J Am Coll Cardiol 2024; 83 (21) 2037-2048
  • 26 Boonman-de Winter LJ, Rutten FH, Cramer MJ. et al. High prevalence of previously unknown heart failure and left ventricular dysfunction in patients with type 2 diabetes. Diabetologia 2012; 55 (08) 2154-2162
  • 27 Dal Canto E, Ceriello A, Rydén L. et al. Diabetes as a cardiovascular risk factor: an overview of global trends of macro and micro vascular complications. Eur J Prev Cardiol 2019; 26 (2_suppl): 25-32
  • 28 Jia G, Hill MA, Sowers JR. Diabetic cardiomyopathy: an update of mechanisms contributing to this clinical entity. Circ Res 2018; 122 (04) 624-638
  • 29 Januzzi Jr JL, Butler J, Del Prato S. et al. Rationale and design of the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure Trial (ARISE-HF) in patients with high-risk diabetic cardiomyopathy. Am Heart J 2023; 256: 25-36
  • 30 Januzzi Jr JL, Butler J, Del Prato S. et al. Randomized trial of a selective aldose reductase inhibitor in patients with diabetic cardiomyopathy. J Am Coll Cardiol 2024; 84 (02) 137-148
  • 31 McDonagh TA, Metra M, Adamo M. et al; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021; 42 (36) 3599-3726
  • 32 Writing Committee Members, ACC/AHA Joint Committee Members. 2022 AHA/ACC/HFSA Guideline for the management of heart failure. J Card Fail 2022; 28 (05) e1-e167
  • 33 Pitt B, Filippatos G, Agarwal R. et al; FIGARO-DKD Investigators. Cardiovascular events with finerenone in kidney disease and type 2 diabetes. N Engl J Med 2021; 385 (24) 2252-2263
  • 34 Bakris GL, Agarwal R, Anker SD. et al; FIDELIO-DKD Investigators. Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. N Engl J Med 2020; 383 (23) 2219-2229
  • 35 Solomon SD, McMurray JJV, Vaduganathan M. et al; FINEARTS-HF Committees and Investigators. Finerenone in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med 2024; 391 (16) 1475-1485
  • 36 Packer M, Zile MR, Kramer CM. et al; SUMMIT Trial Study Group. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med 2025; 392 (05) 427-437
  • 37 Kosiborod MN, Abildstrøm SZ, Borlaug BA. et al. Design and baseline characteristics of STEP-HFpEF program evaluating semaglutide in patients with obesity HFpEF phenotype. JACC Heart Fail 2023; 11 (8 Pt 1): 1000-1010