Last September, there was a breakthrough in medicine, particularly in the fight against heart failure, and Oakville cardiologist Dr. Micheal Heffernan played a critical role in its development.
In the medical field, there are two types of heart failure:
- Reduced ejection fraction - the heart's left ventricle is damaged and cannot pump enough blood out of the heart to keep the body working. A heart attack is often associated with this phenomenon. Several medications are used for this, and the medical community has done a relatively good job of helping these patients.
- Preserved ejection fraction - the heart doesn't relax very well. The heart cannot regulate properly has difficulty pumping blood to the body. There have been no treatments for preserved ejection fraction before last September.
However, a new medical breakthrough has brightened the future for many patients dealing with heart failure. Empagliflozin (JARDIANCE™), a treatment commonly used for diabetes, has shown promise, with a significant improvement in heart failure outcomes of adult patients with preserved ejection fraction.
Within the last week, Health Canada has now approved Empagliflozin as a form of treatment to reduce the risk of cardiovascular death. It is to be used during heart failure hospitalization. It is the first and only medication granted this indication from Health Canada across the entire spectrum of heart failure.
In an interview with Dr. Micheal Heffernan EMPEROR-Preserved clinical investigator and cardiologist at Oakville Trafalgar Memorial Hospital, here are the statistics concerning heart failure in Canada.
- 750,000 Canadians have heart failure, with 100,000 being diagnosed annually.
- Many of these patients are taken care of in the OTMH Heart Function Clinic, with over 800 patients with heart failure registered.
- According to the Oakville cardiologist, concerning these 800 or more patients, half of these patients have reduced ejection fraction, and the other half is preserved ejection fraction.
Empagliflozin is used for both types of heart failure. This is celebrated news for medical practitioners and heart failure patients alike because we have had no therapies approved for preserved ejection fraction until now. None have been shown to have a statistical benefit.
"The risk of death is comparable to most cancers," said Dr. Heffernan. "It is really tough to have a common disease and not have effective therapy. As clinicians, we now have something we can offer, and from the patient's standpoint, they have a medicine that can grant them peace of mind."
"We can recognize that they are very pleased that we have something we can give them which reduces the risk of being hospitalized for heart failure. Both the clinicians and patients reported that they felt better."
As far as regulation and administration of Empagliflozin goes, Health Canada has approved it.
- The availability of Empagliflozen varies across Canada, depending on the province.
- This is widely available across Ontario and is not restricted by the Provincial Drug Plan.
- The Ontario Drug Benefit Program covers it.
"The therapies we were using just two years ago may have helped reduce the symptoms a little bit, but they are unproven therapies for reducing long-term risk. We can now give patients something that we recognize will reduce harmful situations on patients."