Lifetime benefits of comprehensive medical therapy in heart failure with mildly reduced or preserved ejection fraction

This week, we would like to present the article: « Lifetime benefits of comprehensive medical therapy in heart failure with mildly reduced or preserved ejection fraction », recently published in Nature Medicine and co-authored with one of our Advisory Board members Faiez Zannad.
❤️ Individual improvement in events related to heart failure (HF) with mildly reduced (HFmrEF) or preserved ejection fraction (HFpEF) has been demonstrated with the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and the nonsteroidal mineralocorticoid receptor antagonist (nsMRA) finerenone. In addition, in patients with HF, the use of an angiotensin and neprilysin receptor inhibitor (ARNI) improves these outcomes.
❤️ However, the question posed by the authors of this paper is whether there is an expected benefit from the combined use of these agents in the long-term treatment of HFmrEF)/HFpEF.
❤️ The DELIVER, FINEARTS-HF, and PARAGON-HF trials have provided comprehensive data on HF, and cross-analysis of the combined use of treatments shows that the combination of SGLT2i and nsMRA reduces the risk of CV death or first HF worsening by 31% in the overall population, while the combined use of SGLT2i, nsMRA, and ARNI reduces the risk by 39% in patients with HFmrEF)/HFpEF.
❤️ Therefore, long-term use of combined SGLT2i and nsMRA therapy in a 65-year-old patient with HFmrEF/HFpEF, or combined SGLT2i, nsMRA and ARNI in a 65-year-old patient with LVEF < 60% should result in long-term gains of 3.6 (2.0-5.2) or 4.9 (2.5-7.3) additional years without CV death or HF events, respectively.
❤️ It should be noted that combination therapy is expected to result in significant gains in event-free survival across a wide age range, from 55 to 85 years of age, which is a considerable advance, as are the potential long-term cumulative effects of early combination medical therapy with SGLT2i and nsMRA (and ARNI in some individuals) in patients with HFmrEF)/HFpEF.

@Muthiah Vaduganathan, Brian Claggett , Safia Chatur, @Akshay S. Desai, Pardeep Jhund, Orly Vardeny, Béla Merkely MD, PhD, Felipe Martinez, Josep Comin-colet, @José Francisco Kerr Saraiva, @Sanjiv J. Shah, @Carolyn S. P. Lam, Faiez Zannad, Kieran Docherty, @John J. V. McMurray, @Scot D Solomon.
Nat Med. 2026 Jan;32(1):325-331. doi: 10.1038/s41591-025-04037-3. Epub 2025 Oct 6. PMID: 41052644; PMCID: PMC12823412.

INI-CRCT Dissemination WP5: Alexandre Mebazaa, Gérard London, Jean-Noel Trochu Romain Eschalier, Marilucy Lopez Sublet Steven Macari
JACC Adv. 2025 Dec;4(12 Pt 2):102359. doi: 10.1016/j.jacadv.2025.102359. PMID: 41447279.

⛈️❄️This week, we would like to highlight an article in which several members of our network played key roles entitled « The Impact of Meteorological Variables on Heart Failure Hospitalizations » published in JACC Advances by Stefano Coiro, Claire Lacomblez, Guillaume Baudry Francois Roubille, Oren Caspi, Luca Monzo, Kevin Duarte, Tahar Chouihed, MD, PhD, and Nicolas GIRERD. 🌨️ 🌤️
🌡️Indeed, the increased risk of hospitalizations for heart failure (HF) during cold weather is well known.
🌡️However, a wide range of meteorological variables and exposure periods may be taken into account.
🌡️This original study examined not only the effect of temperature, but also relative humidity, atmospheric pressure, and precipitation during different exposure periods.
🌡️This is a retrospective analysis of 4,512 patients admitted for acute dyspnea and diagnosed with acute HF in the emergency department of Nancy University Hospital (2010-2022 as part of the PARADISE study (Pathway of Dyspneic patients in Emergency).
🌡️A calculation of averages was performed for different periods prior to admission to the emergency department.
🌡️Multivariate Poisson regression showed an inverse association between temperature and hospitalizations for heart failure across all periods (incidence rate ratio [IRR] ∼0.90 for each 5°C increase; all P < 0.001) was demonstrated with multivariate Poisson regression.
🌡️This was compounded by an increase in precipitation over a week or a month (IRR for 5 mm = 1.11 and 1.18, respectively; P < 0.035 in both cases) and an increase in atmospheric pressure over a month (IRR for 5 hPa = 1.06; P = 0.003).
🌡️This paper concludes that temperature is independently associated with hospitalizations for heart failure, but the risk increases up to one week of exposure, allowing events related to heart failure to be predicted over this period.
The full article is available with open access here:
https://www.jacc.org/doi/10.1016/j.jacadv.2025.102359

JACC Adv. 2025 Dec;4(12 Pt 2):102359. doi: 10.1016/j.jacadv.2025.102359. PMID: 41447279.

The entire INI-CRCT network team wishes you a year filled witch success and scientific progress.

The KDIGO 2026 Clinical Practice Guideline for Anemia in Chronic Kidney Disease (CKD) provides updated, evidence-based recommendations and practice points to support the diagnosis, evaluation, and management of anemia in adults and children with chronic kidney disease (CKD), including individuals treated with dialysis or kidney transplantation. This guideline updates the KDIGO 2012 Anemia in CKD Guideline and reflects more than a decade of new evidence in anemia pathophysiology and treatment. The guideline was co-chaired by Jodie Babitt, MD (United States), and Marcello Tonelli, MD, SM, MSc, FRCPC (Canada).

Anemia is a common and burdensome complication of CKD, associated with reduced quality of life, increased cardiovascular risk, and a greater reliance on red blood cell transfusions. The updated guideline reflects advances in the understanding of anemia pathophysiology and treatment, and offers practical guidance across the full spectrum of CKD stages and care settings.

The KDIGO 2026 Anemia in CKD Guideline was developed using a rigorous and transparent methodology, including systematic reviews of the evidence and formal assessment of certainty using the GRADE approach. In addition to graded recommendations, the guideline includes population-based treatment algorithms and practice points designed to support consistent, evidence-informed anemia care across diverse healthcare systems, resource settings, and patient populations worldwide.

Excited to announce our new analysis from the Phase 3 PRECISION study is now published in Hypertension, a journal of the American Heart Association.

As an author and a PRECISION investigator, I’m proud to share this comprehensive analysis evaluating the efficacy and safety of a novel treatment in patients with chronic kidney disease and confirmed resistant hypertension.

Key highlights:
1.       Robust evidence supporting blood pressure management in a population with high cardiovascular risk.
2.       Safety profile consistent with the Phase 3 PRECISION study.
3.       Potential implications for clinical practice in managing resistant hypertension among CKD patients.

EP PerMed – CARMEN2026 – Appel à projets transnational conjoint 2026 – Médecine Personnalisée pour les maladies CARdiovasculaires, MEtaboliques et réNales

Dans le cadre du partenariat Européen pour la médecine personnalisé, EP PerMed (soutenus par l’Union européenne dans le cadre d’Horizon Europe, accord de subvention n° 101137129), L’Agence Nationale de la Recherche, en partenariat avec 38 organismes de financement, lance son appel à projets transnational conjoint sur le thème « Médecine Personnalisée pour les maladies CARdiovasculaires, MEtaboliques et réNales (CARMEN2026) ». Le budget disponible pour cet appel est de 38 Mio€ (env.).

Les pays suivants (27) participent à la préparation de l’appel : Afrique du Sud, Allemagne, Autriche, Belgique, Danemark, Espagne, Estonie, Finlande, France, Grèce, Hongrie, Islande, Israël, Irlande, Italie, Lettonie, Lituanie, Luxembourg, Norvège, Pays-Bas, Pologne, Portugal, République Tchèque, République Slovaque, Roumanie, Suède, et Turquie. Quatre des pays participants sont représentés par leur régions respectives (9) : Flandre (Belgique), Fédération Wallonie- Bruxelles (Belgique), Lombardie (Italie), Toscane (Italie), Açores (Portugal), Région Centre (Portugal), Andalousie (Spain), Catalogne (Espagne) et Navarre (Espagne).

Par cet appel, EP PerMed financera des projets de recherche en santé humaine portant sur des stratégies innovantes de médecine personnalisée pour les patients atteints de maladies cardiovasculaires, métaboliques ou rénales. Les projets de recherche peuvent se concentrer sur une seule maladie ou explorer ces affections en combinaison.

Les projets de recherche devront aborder un ou plusieurs des aspects suivants :

• Le développement et la validation d’approches thérapeutiques personnalisées et innovantes pour le traitement de maladies cardiovasculaires, métaboliques ou rénales, et qui seront testées dans des modèles précliniques (ex : culture de cellules humaines, organoïdes, organes-sur-puce, modèles animaux spécifiques, modèles in-silico).
• L’identification et la validation de marqueurs ou signatures moléculaires, ainsi que de technologies de pointe, permettant de déterminer le dosage optimal des traitements, d’en suivre l’efficacité ou d’évaluer le risque d’effets indésirables, afin de personnaliser le parcours de soins, y compris dans le cadre de traitements combinés, des patients atteints de maladies cardiovasculaires, métaboliques ou rénales.
• L’identification et la validation de marqueurs ou signatures moléculaire de stratification, ainsi que de technologies de pointe de stratification, afin de développer des méthodes diagnostiques permettant de prédire et prévenir les comorbidités chez les patients atteints de maladies cardiovasculaires, métaboliques et rénales, et ainsi retarder la progression vers un syndrome cardiovasculaire-rénal-métabolique.

Dans le cadre de cet appel, bien que la recherche clinique puisse être financée, les essais cliniques de grande envergure ne sont pas éligibles. Les études cliniques proposées doivent être réalisables et pouvoir être menées à bien dans les délais et le budget prévus par cet appel.

Seuls les projets transnationaux seront financés.

L’ANR financera les partenaires français des projets sélectionnés. En respect avec les engagements de l’ANR, les participants s’engagent à déposer leurs publications au sein d’archives ouvertes, et à respecter le protocole de Nagoya concernant l’utilisation des ressources génétiques.

Continuation vs Discontinuation of Renin-Angiotensin System Inhibitors Before Major Noncardiac SurgeryThe Stop-or-Not Randomized Clinical Trial

What’s the impact of pre-operative cardiovascular risk on outcome of continuation vs discontinuation of renin-angiotensin system inhibitors before major non cardiac surgery? For an answer check this out. 

🔬 Now Hiring: Postdoctoral Researcher in Cardiovascular Systems Biology (Nancy, France)
We are looking for a Postdoctoral Researcher (24 months) to join Clinical Investigation Center CIC-P 1433 / Inserm UMR_S 1116 (DCAC)  in Nancy, France.

🎯 Project focus:
Endothelial glycocalyx alterations in HFpEF, using biomarkers, proteomics, multimodal data integration, and machine learning. The position is part of the EGAL-HF project, an ANR-funded program at the crossroads of cardiology, systems biology, and AI.

🛠️ You will work on:
• Integrating large clinical & omics datasets (STANISLAS, HOMAGE, ALDO-DHF, MEDIA-DHF)
• Modeling biological networks & HFpEF mechanisms
• Evaluating preventive therapeutic strategies (MRAs)
• Developing an integrated risk-stratification model

👤 Profile:
• PhD in a relevant field
• Strong skills in bioinformatics / biostatistics / ML
• Experience with R/Python/SAS and omics or clinical datasets
• International experience is a plus

📍 Nancy, France
🗓️ Start: March 2026 | 📅 Duration: 24 months
💶 Salary: €2,895–3,287 gross/month
⏳ Deadline: 15 January 2025
📩 Apply / Contact: 

n.girerd@chru-nancy.fr

/ EGAL-HF post-doc
Feel free to share with potential candidates — we’re excited to welcome a motivated researcher to our team!

Nous avons eu le plaisir de réunir l’ensemble de nos équipes et partenaires à l’occasion de notre meeting annuel, qui s’est tenu les 26 et 27 novembre à Monaco.

Au programme : Table ronde, partage d’expérience et des moments de convivialité pour poursuivre ensemble nos ambitions. Merci à toutes et à tous pour votre participation et votre engagement.

The CVCT Workshop is an exclusive, high-level in-person meeting by invitation only, featuring a carefully selected group of expert faculty.

The workshop hosts a limited number of participants (40-50), including authoritative cardiologists, clinical trialists, principal investigators, and statisticians from academia, as well as senior R&D pharma experts, NIH representatives, and international regulatory experts.

The primary objectives of the CVCT Workshop are to enhance clinical trials, streamline regulatory approval processes, and facilitate the implementation of trial-based evidence.

This workshop aims to cultivate a multi-stakeholder exchange of ideas rather than the establishment of guidelines or rules.