A monthly #Cardiology journal club that meets on Twitter produced by @CardioNerds‼️ Use #CardsJC & join the conversation!
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CardioNerds Journal Club retweeted
Applications for the next cohort of the @CardioNerds Academy are due April 28th!
🌟 Revised curriculum tailored to the evolving landscape of digital MedEd
🌟 Develop skills in scientific writing, visual graphic creation, & podcast development
🔗docs.google.com/forms/d/e/1F…
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🖊Sign up for our newsletter to find dates and topics for future @CardioNerdsJC - cardionerds.us4.list-manage.…
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Stay tuned for more updates and deep dives into the latest cardiology trials. Thanks for joining and sharing your insight! 🫀🩺
@CardioNerdsJC #CardsJC
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Thank you to our incredible 🤩@CardioNerds team and academy fellows! shout out to @a_radakrishnan @AkivaRosenzveig @AGangavelli @ShazliKhanMD
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And thats a wrap! Thanks for all the help from our incredible panel of experts #CardsJC
@MartinMaronMD @SrihariNaiduMD @ChrisKramerMD @WilsonTangMD @SonuAbrahamMD @purviparwani @DesaiMilindY @vycMD
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Have you changed your HCM treatment strategy based on any recent trials? Share your experiences and thoughts! 💬❤️👇
#CardsJC
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Takeaway: SEQUOIA-HCM challenges the status quo in HCM treatment and presents a novel option that is shown to provide symptomatic benefit to patients.
Will aficamten become the standard of care? Will these results impact your practice?
#CardsJC
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Clinically, this is relevant since aficamten can improve the way that pts with obstructive HCM feel and function.
This trial highlights the benefits of CMI drug therapy in pts with obstructive HCM, which were similar to the recent findings seen with mavacamten.
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Is the exercise capacity benefit of aficamten 5-20mg in pts with symptomatic HCM believable?
#CardsJC
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Did aficamten cause any 📉in EF?
🚨EF in aficamten group was modestly lower by –4.8% (–6.3, –3.2)
🚨 After washout, no Δ in LVEF in both groups: –1% (–2, 0)
🚨 Transient ⬇️ of < 50% in EF in 5 pts (3.5%) in aficamten group and in 1 pt (0.7%) in placebo group
Thoughts? #CardsJC
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Any thoughts about the prevalence of adverse events in each group?
🚨Serious AE in 8 patients (5.6%) in the aficamten group and in 13 patients (9.3%) in the placebo group
#CardsJC
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What about the secondary outcomes?
⭐️ Δ in KCCQ-CSS: 12 vs. 5*
⭐️ Δ in LVOT gradient ≤30 mm Hg after Valsalva: 49.3% vs. 3.6%*
⭐️ Δ in LVOT gradient: -47.6 vs. 1.8 mm Hg*
⭐️ Δ in NYHA functional class: 58.5% vs 24.3%*
Do these results surprise you?
#CardsJC
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Now what we all have been waiting for, the key finding:
⭐️ Mean change from baseline to week 24 in peak VO2 uptake, for aficamten vs. placebo, was: 1.8 vs. 0.0 mL/kg/min (p < 0.0001)
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Primary endpoint:
Δ in peak oxygen uptake during cardiopulmonary exercise in 24 weeks
Key secondary endpoints:
Δ in peak LVOT gradients
Δ in KCCQ-CSS
Δ in NYHA functional class
Are these endpoints sufficient to answer the objective?
📊🔍
#CardsJC
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Is this a representative HCM population?
Specially looking at:
🌎 79% White patient representation
🧬17.5% with pathogenic sarcomeric variant
💊Prevalence of BB, CCB, disopyramide use
🫀NYHA Class ratio
#CardsJC
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Which patients with HCM were included?
📍LV wall thickness ≥ 15mm
📍EF ≥ 60%
📍LVOT gradient ≥ 30 mm Hg at rest and ≥ 50 mm Hg after Valsalva
📍NYHA II-III
📍⬇️ exercise capacity
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Study design: It is an international, phase 3, double-blinded, randomized placebo-controlled trial involving 80 sites. 🌍
Any thoughts about the design?
#CardsJC
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Trial objective/population: SEQUOIA-HCM aimed to determine the efficacy and safety of aficamten in adult patients with symptomatic obstructive HCM.
#CardsJC
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