Browsing by Author "G.S. Wander"

Now showing 1 - 4 of 4

Consensus Statement from India on the Renal Benefits of ARNi, SGLT-2i, and Bisoprolol in Chronic Kidney Disease
(Journal of Association of Physicians of India, 2024) H.K. Chopra; Dinesh Khullar; Tiny Nair; G.S. Wander; C.K. Ponde; Saumitra Ray; Navin C. Nanda; Ravi R. Kasliwal; D.S. Rana; Ashok Kirpalani; J.P.S. Sawhney; Praveen Chandra; Yatin Mehta; Viveka Kumar; S. Tewari; A.K. Pancholia; Vijay Kher; Sandeep Bansal; Sanjay Mittal; Praful Kerkar; P.K. Sahoo; Ramesh Hotchandani; Sunil Prakash; Nagendra Chauhan; Vishal Rastogi; A. Jabir; S. Shanmugasundaram; Mangesh Tiwaskar; Ajay Sinha; Vittul Gupta; S.S. Mishra; S.N. Routray; A.K. Omar; Onkar C. Swami; Aparna Jaswal; Shamsad Alam; Rajeev Passey; Rajeeve Rajput; Justin Paul; Aditya Kapoor; D. Prabhakar; Subhash Chandra; Poonam Malhotra; Vivudh Pratap Singh; Manish Bansal; Priyank Shah; Sanjay Jain; Mohan Bhargava; I.B. Vijayalakshmi; Kiron Varghaese; Dharmender Jain; Anupam Goel; Namrata Gaur; Rohit Tandon; Asha Moorthy; Sheeba George; V.K. Katyal; R.R. Mantri; Rahul Mehrotra; Dilip Bhalla; Vinod Mittal; Sarita Rao; Manish Jagia; Harmeet Singh; Surabhi Awasthi; Ameet Sattur; Rekha Mishra; Anand Pandey; Rajeev Chawla; Shalini Jaggi; Blessy Sehgal; Alok Sehgal; Naresh Goel; Ripen Gupta; Samir Kubba; Abhinav Chhabra; Saurabh Bagga; N.R. Shastry
Chronic kidney disease (CKD) is a major contributor to morbidity and mortality in India. CKD often coexists with heart failure (HF), diabetes, and hypertension. All these comorbidities are risk factors for renal impairment. HF and CKD are pathophysiologically intertwined, and the deterioration of one can worsen the prognosis of the other. There is a need for safe renal pharmacological therapies that target both CKD and HF and are also useful in hypertension and diabetes. Neurohormonal activation achieved through the activation of the sympathetic nervous system (SNS), the renin–angiotensin–aldosterone system (RAAS), and the natriuretic peptide system (NPS) is fundamental in the pathogenesis and progression of CKD and HF. Angiotensin receptor neprilysin inhibitor (ARNi), sodium-glucose cotransporter 2 inhibitors (SGLT-2i), and selective β1-blocker (B1B) bisoprolol suppress this neurohormonal activation. They also have many other cardiorenal benefits across a wide range of CKD patients with or without concomitant HF, diabetes, or hypertension. This consensus statement from India explores the place of ARNi, SGLT-2i, and bisoprolol in the management of CKD patients with or without HF and other comorbidities. ©The Author(s). 2024.
Current Place of SGLT2i in the Management of Heart Failure: An Expert Opinion from India
(Journal of Association of Physicians of India, 2024) H.K. Chopra; Tiny Nair; G.S. Wander; C.K. Ponde; Saumitra Ray; Dinesh Khullar; Navin C. Nanda; Jagat Narula; Ravi R. Kasliwal; D.S. Rana; Ashok Kirpalani; J.P.S. Sawhney; Praveen Chandra; Yatin Mehta; Viveka Kumar; S. Tewari; A.K. Pancholia; Vijay Kher; Sandeep Bansal; Sanjay Mittal; Praful Kerkar; P.K. Sahoo; Ramesh Hotchandani; Sunil Prakash; Nagendra Chauhan; Vishal Rastogi; A. Jabir; S. Shanmugasundaram; Mangesh Tiwaskar; Ajay Sinha; Vittul Gupta; S.S. Mishra; S.N. Routray; A.K. Omar; Onkar C. Swami; Aparna Jaswal; Shamsad Alam; Rajeev Passey; Rajeeve Rajput; Justin Paul; Aditya Kapoor; D. Prabhakar; Subhash Chandra; Poonam Malhotra; Vivudh Pratap Singh; Manish Bansal; Priyank Shah; Sanjay Jain; Mohan Bhargava; I.B. Vijayalakshmi; Kiron Varghaese; Dharmender Jain; Anupam Goel; Kiran Mehmood; Namrata Gaur; Rohit Tandon; Asha Moorthy; Sheeba George; V.K. Katyal; R.R. Mantri; Rahul Mehrotra; Dilip Bhalla; Vinod Mittal; Sarita Rao; Manish Jagia; Harmeet Singh; Surabhi Awasthi; Ameet Sattur; Rekha Mishra; Anand Pandey; Rajeev Chawla; Shalini Jaggi; Blessy Sehgal; Alok Sehgal; Naresh Goel; Ripen Gupta; Samir Kubba; Abhinav Chhabra; Saurabh Bagga; N.R. Shastry
Heart failure (HF) is a global health concern that is prevalent in India as well. HF is reported at a younger age in Indian patients with comorbidity of type 2 diabetes (T2DM) in approximately 50% of patients. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), originally approved for T2DM, are new guideline-recommended and approved treatment strategies for HF. Extensive evidence highlights that SGLT2i exhibits profound cardiovascular (CV) benefits beyond glycemic control. SGLT2i, in conjunction with other guideline-directed medical therapies (GMDT), has additive effects in improving heart function and reducing adverse HF outcomes. The benefits of SGLT2i are across a spectrum of patients, with and without diabetes, suggesting their potential place in broader HF populations irrespective of ejection fraction (EF). This consensus builds on the updated evidence of the efficacy and safety of SGLT2i in HF and recommends its place in therapy with a focus on Indian patients with HF. ©The Author(s). 2024.
Role of Bisoprolol in Heart Failure Management: A Consensus Statement from India
(Journal of Association of Physicians of India, 2023) H.K. Chopra; Tiny Nair; G.S. Wander; C.K. Ponde; Saumitra Ray; Dinesh Khullar; Navin C. Nanda; Ravi R. Kasliwal; D.S. Rana; Ashok Kirpalani; J.P.S. Sawhney; Praveen Chandra; Yatin Mehta; Viveka Kumar; S. Tewari; A.K. Pancholia; Vijay Kher; Sandeep Bansal; Sanjay Mittal; Praful Kerkar; P.K. Sahoo; Ramesh Hotchandani; Sunil Prakash; Nagendra Chauhan; Vishal Rastogi; A. Jabir; S. Shanmugasundaram; Mangesh Tiwaskar; Ajay Sinha; Vittul Gupta; S.S. Mishra; S.N. Routray; A.K. Omar; Onkar C. Swami; Aparna Jaswal; Shamsad Alam; Rajeev Passey; Rajeeve Rajput; Justin Paul; Aditya Kapoor; D. Prabhakar; Subhash Chandra; Poonam Malhotra; Vivudh Pratap Singh; Manish Bansal; Priyank Shah; Sanjay Jain; Mohan Bhargava; I.B. Vijayalakshmi; Kiron Varghaese; Dharmender Jain; Anupam Goel; Namrata Gaur; Rohit Tandon; Asha Moorthy; Sheeba George; V.K. Katyal; R.R. Mantri; Rahul Mehrotra; Dilip Bhalla; Vinod Mittal; Sarita Rao; Manish Jagia; Harmeet Singh; Surabhi Awasthi; Ameet Sattur; Rekha Mishra; Anand Pandey; Rajeev Chawla; Shalini Jaggi; Blessy Sehgal; Alok Sehgal; Naresh Goel; Ripen Gupta; Samir Kubba; Abhinav Chhabra; Saurabh Bagga; N.R. Shastry
In India, heart failure (HF) is an important health concern affecting younger age groups than the western population. A limited number of Indian patients receive guideline-directed medical therapy (GDMT). Selective β-1 blockers (BB) are one of the GDMTs in HF and play an important role by decreasing the sympathetic overdrive. The BB reduces heart rate (HR) reverse the adverse cardiac (both ventricular and atrial), vascular, and renovascular remodeling seen in HF. Bisoprolol, a β-1 blocker, has several advantages and can be used across a wide spectrum of HF presentations and in patients with HF and comorbid conditions such as coronary artery disease (CAD), atrial fibrillation (AF), post-myocardial infarction (MI), uncontrolled diabetes, uncontrolled hypertension, and renal impairment. Despite its advantages, bisoprolol is not optimally utilized for managing HF in India. This consensus builds on updated evidence on the efficacy and safety of bisoprolol in HF and recommends its place in therapy with a focus on Indian patients with HF. © The Author(s).
The Power and Promise of Angiotensin Receptor Neprilysin Inhibitor (ARNI) in Heart Failure Management: National Consensus Statement
(Journal of Association of Physicians of India, 2023) H.K. Chopra; G.S. Wander; C.K. Ponde; Navin C. Nanda; Dinesh Khullar; K. Venugopal; Saumitra Ray; Tiny Nair; D.S. Rana; Vijay Kher; J.P.S. Sawhney; R.R. Kasliwa; A. Jabir; Rabin Chakraborty; Praveen Chandra; Sandeep Bansal; Viveka Kumar; A.K. Pancholia; Aditya Kapoor; Sunil Prakash; Anil Saxena; Vishal Rastogi; Vinod Sharma; Y.K. Arora; Arup Dasbiswas; Mohan Bhargava; Aparna Jaswal; K. Bhargava; Mona Bhatia; A.K. Omar; N.N. Khanna; Rajiv Passey; Dilip Bhalla; I.B. Vijayalakshmi; A.K. Bhalla; Asha Moorthy; H.S. Isser; S.S. Mishra; S.N. Routray; Vivek Tandon; Ajay Sinha; Manish Bansal; Praveen Jain; Ramesh Hotchandani; Dharmendra Jain; V.K. Katyal; Sanjiv Gulati; Rohit Tandon; Shalini Jaggi; Blessy Sehgal; Vitull Gupta; Rahul Mehrotra; N.C. Krishnamani; S.N. Pathak; M.S. Yadav; Rajeev Chawla; Jyotirmoy Pal; Nandini Chatterjee; Shambo S. Samajdar; N.R. Shastry
Heart failure (HF) is a huge global public health task due to morbidity, mortality, disturbed quality of life, and major economic burden. It is an area of active research and newer treatment strategies are evolving. Recently angiotensin receptor-neprilysin inhibitor (ARNI), a class of drugs (the first agent in this class, Sacubitril–Valsartan), reduces cardiovascular mortality and morbidity in chronic HF patients with reduced left ventricular ejection fraction (LVEF). Positive therapeutic effects have led to a decrease in cardiovascular mortality and HF hospitalizations (HFH), with a favorable safety profile, and have been documented in several clinical studies with an unquestionable survival benefit with ARNI, Sacubitril–Valsartan. This consensus statement of the Indian group of experts in cardiology, nephrology, and diabetes provides a comprehensive review of the power and promise of ARNI in HF management and an evidence-based appraisal of the use of ARNI as an essential treatment strategy for HF patients in clinical practice. Consensus in this review favors an early utility of Sacubitril–Valsartan in patients with HF with reduced EF (HFrEF), regardless of the previous therapy being given. A lower rate of hospitalizations for HF with Sacubitril–Valsartan in HF patients with preserved EF who are phenotypically heterogeneous suggests possible benefits of ARNI in patients having 40–50% of LVEF, frequent subtle systolic dysfunction, and higher hospitalization risk. © 2023 Journal of Association of Physicians of India. All rights reserved.