UMIPIC
7.5K posts
@UMIPIC
Unidades Manejo Integral de Pac. con Insuficiencia Cardíaca. Grupo de trabajo Soc. Española de Med. Interna. #heartfailure #nursing #medicine #SEMItuit #41SEMI
Dicen que una imagen vale más que 1000 palabras, y esta ha sido la ultima diapositiva mostrada hoy en #HeartFailure26. No, esta imagen no muestra el trabajo realizado estos dos últimos años por M. Jesus Vicente, Maria Pumares y Eva García...pero si nos dice que hay que seguir
🌳 DECISION/DIGIT-HF/DIG — Study-level meta-analysis (~9,000 patients) When you pool all the digitalis glycoside RCT evidence, the picture becomes much clearer. Presented by Kevin Damman at #HeartFailure26 📊 Primary endpoint (CV death or first worsening HF event): • DIG (1997): HR 0.85 [0.79–0.91] • DIGIT-HF (2025): HR 0.85 [0.71–1.02] • DECISION (2026): HR 0.83 [0.66–1.05] • OVERALL: HR 0.85 [0.80–0.90], P < 0.001 ✓ I² = 0% — zero heterogeneity 📊 Secondary endpoints: ✅ First worsening HF event: HR 0.75 (0.75–0.81), P < 0.001 ❌ CV death: HR 0.99 (0.92–1.07), P = 0.81 ✅ All-cause death or worsening HF: HR 0.85 (0.80–0.90), P < 0.001 ❌ All-cause death: HR 0.97 (0.90–1.04), P = 0.41 🔑 The meta-analytic verdict: ✅ Digitalis reduces HF events & composite outcomes significantly ❌ No mortality benefit (CV or all-cause) ✅ Zero heterogeneity — consistent effect across all three trials, eras, and doses The drug works for congestion & worsening HF. It doesn't extend life. That's the honest summary of ~30 years of evidence. #Digoxin #DIG #DIGITHF #DECISION #MetaAnalysis #HeartFailure2026 #CardioTwitter
🧵 Why do loop diuretics stop working in acute heart failure? Dr. Ana Belen Mendez Fernandez breaks it down at #HeartFailure26 Diuretic resistance = mismatch between drug delivery & tubular response. 3 main culprits: 1️⃣ Impaired drug delivery • Gut edema → poor oral absorption • Reduced renal perfusion • Hypoalbuminemia 2️⃣ Tubular adaptation (“braking phenomenon”) • Distal nephron hypertrophy • ↑ Na reabsorption distal to loop of Henle 3️⃣ Neurohormonal activation • RAAS activation • Sympathetic nervous system activation Know the mechanism → pick the right counterstrategy 💡 #CardioTwitter #HeartFailure #Cardiology #Diuretics
