News & Updates

Improving outcomes with a soluble guanylate cyclase stimulator in patients with worsening HF

Although guideline-directed medical therapies (GDMTs) for heart failure (HF) with reduced ejection fraction (HFrEF) are effective in reducing risks of mortality and hospitalization for HF (HHF), the clinical burden of HF remains high. At a recent scientific symposium, Dr Yuya Matsue of Juntendo University Graduate School of Medicine in Japan discussed strategies of tackling worsening HF (WHF) to improve patient outcomes and presented a case study of vericiguat in HFrEF. 

SGLT2 inhibitor as GDMT in an elderly female with chronic HFpEF

An 81-year-old homebound, obese (BMI, 31 kg/m²) female complained of dyspnoea on exertion and exercise intolerance in 2023. The patient often needed to stop after walking for a distance of two blocks or climbing eight steps of stairs (New York Heart Association [NYHA] functional class II), which limited her daily and social activities.

Androgen receptor inhibitor plus chemotherapy and ADT in a patient with mHSPC and multiple comorbidities

A 66-year-old male nonsmoker and nondrinker complained of generalized bone pain, poor appetite and abdominal discomfort in December 2022. He had hypertension, which was controlled with amlodipine/valsartan 5 mg/80 mg, and sleep apnoea. He was also a hepatitis B virus (HBV) carrier on maintenance entecavir. He had no family history of prostate cancer.

Long-acting antiretroviral therapy in holistic management of an elderly patient with HIV

A 70-year-old female garment factory worker presented with an incidental finding of HIV infection following a diagnosis of pulmonary tuberculosis (PTB). She was screened positive after her partner received a diagnosis of HIV/PTB coinfection. 

Cardiorenal protection with an SGLT2 inhibitor in a patient with T2DM and multiple comorbidities

A 65-year-old female overweight security guard with a 10-year history of type 2 diabetes mellitus (T2DM) was referred to our centre from a general outpatient clinic in 2019 due to suboptimal glycaemic control (HbA_1c, 8–9 percent) since diagnosis.

PCSK9 inhibitor use in a young patient with FH and an elderly patient with statin intolerance

A 27-year-old male was admitted to hospital on 29 April 2023 due to sudden-onset severe chest pain and shortness of breath on his way to work. He had no notable past medical history. ECG showed ST elevation over inferior leads. His high-sensitivity cardiac troponin T was extremely elevated at 1,902 ng/L. He was diagnosed with acute myocardial infarction (MI).

In-hospital initiation of an SGLT2 inhibitor in an elderly patient with acute heart failure

A 76-year-old female was hospitalized in July 2023 due to a 3-month history of shortness of breath (SoB), lower limb oedema and reduced exercise tolerance with New York Heart Association (NYHA) functional class II. At the time of hospitalization, she experienced acute pulmonary oedema, which was effectively treated with intravenous furosemide supported by a short course of continuous positive airway pressure (CPAP) ventilation. The patient also had multiple comorbidities on background medications, including hypertension treated with losartan 25 mg daily and amlodipine 10 mg daily, type 2 diabetes mellitus (T2DM) treated with metformin 500 mg BID, atrial fibrillation treated with apixaban 5 mg BID, as well asobesity and obstructive sleep apnoea.

Use of a PCSK9 inhibitor in a patient with established ASCVD

A 54-year-old nonsmoking Australian male with a known history of hypertension presented with chest discomfort in September 2019. His LDL-cholesterol (LDL-C) level was 2.2 mmol/L. Coronary CT angiography in 2011 indicated mild stenosis at the left anterior descending (LAD) and left circumflex (LCX) arteries. However, assessment in September 2019 revealed stenosis progression, with 50–70 percent stenosis in the proximal LAD (p-LAD) artery and 50 percent stenosis in the proximal LCX (p-LCX) artery. Pulmonary CT angiography showed segmental pulmonary embolism (PE). Ultrasonography showed left lower limb deep vein thrombosis (DVT).

Prioritizing cardiorenal protection in T2DM, HF & CKD: Why SGLT2 inhibitors?

Sodium-glucose cotransporter 2 (SGLT2) inhibitors’ (eg, empagliflozin) cardiorenal benefits demonstrated in patients with type 2 diabetes mellitus (T2DM), heart failure (HF) and chronic kidney disease (CKD) have led to guideline recommendations for their use across these populations. In a Boehringer Ingelheim–sponsored lecture at the 6^th Annual Meeting of Endocrinology, Diabetes & Metabolism Hong Kong (EDM HK), Professor Dirk Müller-Wieland of the RWTH University Hospital Aachen in Aachen, Germany, discussed how these cardiorenal-protective therapies improve patients’ prognosis, highlighting international guidelines that now recommend SGLT2 inhibitors for cardiorenal risk reduction in T2DM patients with atherosclerotic cardiovascular disease (CVD), HF patients regardless of left ventricular ejection fraction (LVEF) and diabetes status, and CKD patients.

Robust evidence for fenofibrate in patients with metabolic syndrome on statins