CTCPR Trials & CIRL

🫀Are patients with atrial fibrillation better protected with high-dose influenza vaccines? New study by @Espersen_C & @CTCPR_ (@ACCinTouch) using DANFLU-2: - n=332,438 adults ≥65 years - 34,085 (10.3%) with AF - Randomized to high-dose vs standard-dose influenza vaccine across 3 seasons 🔑Key findings: AF patients had markedly higher risks of influenza-related & cardiovascular hospitalizations High-dose vaccine ↓ hospitalizations for: - Cardiorespiratory disease - Influenza (incl. lab-confirmed) - Cardiovascular disease Effects consistent regardless of AF status Greater absolute benefit in AF (NNV ~243 vs ~933 in non-AF) Worth noting: The trial was not powered for the AF subgroup analyses, meaning these findings should be considered hypothesis-generating. Implication: In high-risk populations like AF, vaccine choice—not just vaccination—may matter 🫀 📄 Study link: sciencedirect.com/science/articl… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @RebeccaCHarris @matslassen @KristofferSkaar @niklasdj1 @AM_reimer @dons_maria @KBernholm @fdavidovski_MD @LisaSteenDuus @camillaiottosen @AnneBjergn @drJBorchsenius @katjabartholdy @AdamLanghoff @MortenSengelov

🫀Are CKD patients underprotected during flu season? New study by @katjabartholdy & colleagues from @CTCPR_ using DANFLU-2 (n=332,438; 14% CKD) has been published in the journal of @ACCinTouch Key findings: • HD vaccine ↓ flu/pneumonia hosp. by 16.9% in CKD (vs 0.6%) • ↓ influenza hosp. by 68.6% in CKD • Cardiorespiratory benefits consistent across groups Important context: The trial was not powered for the CKD subgroup analyses, so these findings should be considered hypothesis-generating. Implication: Vaccine choice may matter most in high-risk patients🫀 Full study: sciencedirect.com/science/articl… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @RebeccaCHarris @matslassen @KristofferSkaar @niklasdj1 @AM_reimer @dons_maria @KBernholm @fdavidovski_MD @LisaSteenDuus @camillaiottosen @AnneBjergn @drJBorchsenius @Espersen_C @AdamLanghoff @MortenSengelov

🫀Key insight: Inflammation may drive early cardiac dysfunction in psoriasis New study by @dons_maria & @CTCPR_ (Int J Cardiol – Heart & Vasculature), n=972 Highlights: ↑ hsCRP → ↓ GLS & LVEF Highest hsCRP tertile → more systolic & diastolic dysfunction hsCRP >2 mg/L → +45% odds of myocardial dysfunction Implication: hsCRP may help identify early CV risk in psoriasis 📄 Study link: sciencedirect.com/science/articl… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @niklasdj1 @MortenSengelov @fdavidovski_MD @matslassen @KristofferSkaar @drJBorchsenius

Today we at @CTCPR_ started recruitment for our most recent GIGA trial, the DAN-ZOSTER trial: clinicaltrials.gov/study/NCT07485… In DAN-ZOSTER we will randomize 162,000 participants to assess whether a shingles vaccination may reduce the future risk of cardiovascular disease and dementia

🫀Can machine learning unlock hidden signals in echo data? New study by @JakobOeystein & @CTCPR_ (International Journal of Cardiology) applies machine learning to full strain & tissue Doppler imaging curves. Key findings: 🤖Better prediction of HF & CV death vs. conventional echo 📈Deformation curves hold added prognostic info 🔬Potential for future risk models Early-stage—but promising for smarter CV risk stratification. Study link: internationaljournalofcardiology.com/article/S0167-… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @matslassen @niklasdj1 @KristofferSkaar @fwemmer1

🫀Can echo predict kidney disease in HFrEF? Study by Ali Hikmat Al-Rubai & @CTCPR_ (Echocardiography): n=1,138, ~10y follow-up ✔️Worse cardiac function → higher KD risk ✔️LVEF, TAPSE & E/e’ independently predicted incident KD ✔️~21% developed KD Echo may help identify high-risk HF patients early. Study link: onlinelibrary.wiley.com/doi/epdf/10.11… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @Espersen_C @MortenSengelov @MananPareekMD @fdavidovski_MD

🫀 Does influenza vaccine dose matter in hypertension? New study by @AdamLanghoff & @CTCPR_ (Journal of Clinical Hypertension) using DANFLU-1 data (n=12,477; ~52% with HTN): ✔️High-dose vaccine ↓ hospitalizations (influenza/pneumonia, respiratory) ✔️↓ all-cause mortality ✔️Benefits consistent regardless of HTN Supports HD-IIV use in older adults. Study link: onlinelibrary.wiley.com/doi/10.1111/jc… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @niklasdj1 @AM_reimer @KiraJanstrup @RebeccaCHarris @katjabartholdy @Espersen_C

Great to see our team from @CTCPR_ at #ESCMIDGlobal - @ESCMID Several of our researchers presented new data from DAN-RSV, DANFLU-2 & FLUNITY-HD across oral, ePoster & poster sessions. Strong science, great discussions, and valuable international collaborations. 📸 @TorBiering @niklasdj1 @AM_reimer @KBernholm @fdavidovski_MD @drJBorchsenius @Espersen_C

📩 Can digital nudges boost vaccination—year after year? In a nationwide RCT (n=308,978), @niklasdj1 & colleagues from @CTCPR_ (@NEJMEvidence) show: - Vaccination rates increased from 24.1% (usual care) → 36.5% (any letter) - All e-letters were effective - Best: repeated CV-focused message → 39.1% (+15.0 pp) 💡Scalable, low-cost nudges works—and persist across seasons. 📄 Study link: evidence.nejm.org/doi/10.1056/EV… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @KiraJanstrup

🫀New study by @niklasdj1 & colleagues from @CTCPR_, published in @CircAHA 📊New data from FLUNITY-HD, one of the largest pooled randomized datasets to date (n=466,320; 23% with prior CVD) 🔍HD vs SD influenza vaccine: ↓ any CVD hospitalization: 1.15% vs 1.24% (rVE 6.6%) ↓ respiratory hospitalization: 0.92% vs 0.98% (rVE 6.5%) ↓ HF hospitalization: 0.11% vs 0.15% (rVE 21.3%) ↓ influenza/pneumonia & all-cause hospitalizations Effects were consistent regardless of pre-existing CVD (no interaction) Signals point to meaningful reductions in both cardiovascular & respiratory events with high-dose vaccination in older adults 📄Full study: ahajournals.org/doi/10.1161/CI… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @RebeccaCHarris

🫀New study by @MaratYafasov & colleagues from @CTCPR_, published in Clinical Research in Cardiology In a general population cohort (n=1,954), LA reservoir strain (LASr) by 3D echo predicted HF/CV death. 🔍Each 5% ↓ in LASr led to 28% ↑ risk ⚠️Other LA strain measures were not independently associated 💡A promising early marker for risk stratification 📄Full study: link.springer.com/article/10.100… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @matslassen @niklasdj1 @KristofferSkaar @fwemmer1

🫁New study by @LisaSteenDuus and colleagues from @CTCPR_, published in Respiratory Investigation In the DANFLU-1 randomized trial (n=12,477), adults 65–79 were assigned 1:1 to high-dose vs. standard-dose influenza vaccines. Outcomes were tracked via nationwide registries. 🔍Key findings: - Patients with chronic lung disease (CLD) had higher hospitalization rates across all outcomes - High-dose vaccines reduced pneumonia/influenza hospitalizations overall (HR ~0.36) - But in CLD patients, benefits were attenuated (HR ~0.95) Likely underpowered → hypothesis-generating, but highlights need for targeted vaccine strategies in high-risk groups 📄Full study: sciencedirect.com/science/articl… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @niklasdj1 @KiraJanstrup @AM_reimer @RebeccaCHarris

Come and hear the latest science from @CTCPR_ at this year’s #ESCMIDGlobal - @ESCMID Researchers from #CTCPR will present 12 different abstracts through oral presentations, ePoster Flash sessions and poster sessions. These presentations will include multiple sub-analyses of our most recent pragmatic GIGA randomized trials – including DAN-RSV, DANFLU-2 & FLUNITY-HD. Watch out for the simultaneous publications! STAY TUNED! 👉 See our program below @TorBiering @niklasdj1 @AM_reimer @KBernholm @fdavidovski_MD @drJBorchsenius @Espersen_C

🫀SGLT2 inhibitors and cardiac remodeling in CKD – A @NEJMEvidence publication The DECODE-CKD randomized trial was led by @katjabartholdy and colleagues from @CTCPR_, which shows that Dapagliflozin significantly reduced left ventricular mass index vs placebo in patients with chronic kidney disease (−8.44 g/m²). Findings provide mechanistic insight into the cardioprotective effects of SGLT2 inhibitors. 📄Full study: evidence.nejm.org/doi/10.1056/EV… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @matslassen @niklasdj1 @KristofferSkaar @dons_maria @KBernholm @fdavidovski_MD @LisaSteenDuus @camillaiottosen @AnneBjergn @drJBorchsenius @Espersen_C @AdamLanghoff @MortenSengelov

🫀New research on myocardial fibrosis In the @BrJPharmacol, Sheyla Barrado-Ballestero and colleagues from Gubra - together with @CTCPR_ - a whole-heart 3D imaging + deep learning pipeline to map myocardial fibrosis. Treatment with Semaglutide reduced LV hypertrophy and perivascular fibrosis in a cardiometabolic mouse model 💊 📄Study link: bpspubs.onlinelibrary.wiley.com/doi/10.1111/bp… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes

#ACC26 @ACCinTouch delivered this year. Outstanding LBCTs, a tremendous FACC ceremony, a 3rd place in the wellness challenge, and most importantly - good food with great friends! @matslassen @KristofferSkaar @LisaSteenDuus ("Team DAN-RSV") @DLBHATTMD @Ajar_Kochar

Star PhD fellow @LisaSteenDuus presenting her findings on DAN-RSV participants with CKD. 13,364/131,379 (10.2%) had CKD RSVpreF reduced event rates among CKD patients with a possible effect modification by eGFR RSVpreF did not reduce kidney outcomes. Stay tuned for the paper!

New paper in @CircAHA 🫀📊 In older adults, poor CKM health was highly prevalent, with ~88% in stage 3–4. ⬆️ CKM stage → worse 🫀 remodeling + higher HF risk 📈 Stage 4 vs 2: >8x higher risk over ~9 years Link: ahajournals.org/doi/10.1161/CI… @mvaduganathan @TorBiering @CTCPR_

New in @TheLancet @niklasdj1 & colleagues from @CTCPR_ report pooled data (FLUNITY-HD) from 466,320 older adults in Denmark & Spain. High-dose vs standard-dose influenza vaccine: ✅ 8.8% ↓ influenza/pneumonia hospitalization ✅ ↓ cardiorespiratory & all-cause hospitalization = Similar safety Large pragmatic RCT evidence with public health impact. 📄Study link: #preview-section-abstract" target="_blank" rel="nofollow noopener">sciencedirect.com/science/articl… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @RebeccaCHarris @matslassen @kristofferskaarup @AM_reimer @dons_maria @KBernholm @fdavidovski_MD @LisaSteenDuus @camillaiottosen @AnneBjergn @drJBorchsenius @Espersen_C @LiseWittenDavodian @AdamLanghoff @MortenSengelov @katjabartholdy

🔎 New in @JAMANetwork @niklasdj1 and colleagues from @CTCPR_ tested whether digital invitation design affects trial enrollment within DANFLU-2 (n=934,049). 1-page letters outperformed 2-page versions 📄 Color made no difference 🎨 ~1% absolute difference = ~9,800 extra participants per 1M invites. In large pragmatic trials, simplicity matters. 📄 Study link: jamanetwork.com/journals/jama/… @TorBiering @CopCard @RigsHeart @HGHHjerte @Stenodiabetes @RebeccaCHarris