Atherosclerotic Cardiovascular Disease
ISCHEMIA CKD: No Difference In Outcomes Between Medical and Invasive Approaches to Ischemia in Patients with End Stage Renal Disease
The results of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches – Chronic Kidney Disease were presented by Dr. Sripal Bangalore at the American Heart Association 2019 meeting. Dr. Bangalore and his team showed that in patients with moderate ischemia and end-stage renal disease, an initial invasive strategy with catheterization and possibly percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) did not lead to an improvement in clinical outcomes.
COLCOT: Colchicine Reduced Cardiovascular Events in Patients with Recent Myocardial Infarction
The results of the COLCOT trial were presented by Dr. Jean-Claude Tardif at the American Heart Association 2019 conference and published in the New England Journal of Medicine. The study showed that in patients with a recent myocardial infarction, colchicine led to a significantly lower risk of ischemic cardiovascular events than placebo.
Blinded Post-PCI Physiologic Assessment Detected Residual Ischemia After Angiographically Successful Result The DEFINE PCI Study
The result of a study, presented at ACC 2019 in March, 2019 and recently published in JACC Interventional Cardiology, showed that despite angiographically successful percutaneous coronary intervention (PCI), physiological assessment detected residual ischemia in 1 out of 4 patients after coronary stenting. The majority of the cases were due to inappropriate focal lesions which seem amenable to treatment with additional PCI.
THEMIS Study: Ticagrelor Plus Aspirin Associated with Lower Ischemic Event Rate but Higher Bleeding Rate Than Aspirin Alone in Patients with Diabetes and Stable Coronary Artery Disease
Use of ticagrelor plus aspirin in patients with stable coronary artery disease and type 2 diabetes significantly lowers the risk of major adverse cardiovascular events compared with aspirin alone, but at the cost of higher major bleeding, according to the THEMIS study. The results were presented at ESC 2019 and published in the New England Journal of Medicine.
ORION-1: 1-Year Follow-Up Data Affirms 2-dose Regimen Using 300 mg of Inclisiran For Persistent LDL-C Lowering 360-day follow-up results published in September edition of JAMA Cardiology
A randomized, double blind, placebo-controlled, phase II clinical trial studying the effect of a novel protein proprotein convertase subtilisin/kexin type 9 (PCSK9) synthesis inhibitor (inclisiran) on serum low density lipoprotein cholesterol (LDL-C) levels has shown that twice a year subcutaneous injections of inclisiran leads to a sustained dose-dependent reduction in serum LDL-C levels over a period of 1 year.
TWILIGHT Trial: Single Anti-Platelet Therapy (SAPT) Using Ticagrelor Reduces Bleeding Risk And Preserves Ischemia Prevention Post-PCI Following 3 months of dual anti-platelet therapy (DAPT) post-PCI, continuation of anti-ischemic pharmacotherapy with ticagrelor alone safer than extended DAPT
A randomized, double-blinded, placebo-controlled trial which enrolled 7119 high risk patients with coronary artery disease who had undergone recent percutaneous coronary intervention (PCI) has shown that, after 3 months of dual anti-platelet therapy (DAPT) using a P2Y12 receptor blocker (ticagrelor) and aspirin, continuing secondary prevention with a single anti-platelet therapy (SAPT) with ticagrelor alone reduces bleeding as compared to extended DAPT.
New Study Shows Levels of Circulating Cardiovascular Biomarkers Are Different in Men and Women
A study led by Dr. Emily Lau published in the Journal of the American College of Cardiology showed that there were significant differences in circulating biomarkers in men and women. These differences in biomarker levels may reflect the distinct pathways implicated in the pathogenesis of cardiovascular disease in men and women.
HOPE 4: A Comprehensive Community-based Program Surpassing the Barriers in Improving BP Control and Associated Cardiovascular Disease Risk in 2 Middle Income Countries A successful 12-months follow-up open-labeled, cluster-randomized controlled trial
Significant improvement in blood pressure control and related cardiovascular disease (CVD) risk is seen as a result of a potentially effective and pragmatic comprehensive model of care conducted as HOPE 4 trial (Heart Outcomes and Prevention Evaluation-4) presented by Dr. JD Schwalm at the European Society of Cardiology (ESC) Congress 2019 and simultaneously published in The LANCET.
No significant association between myocardial viability & long-term survival benefit of CABG in patients with ischemic cardiomyopathy Results of a 10-year follow-up STICH trial & subsequent myocardial viability sub-study
According to a new study published in The New England Journal of Medicine (NEJM) based on a 10-year follow-up STICH trial, no association was found between myocardial viability as a long-term survival benefit of CABG in patients with ischemic cardiomyopathy.
PolyIran Trial: Polypill Prevents Cardiovascular Events PolyIran Trial: Fixed-Dose Combination Therapy With Aspirin, a Statin and Two Anti-hypertensives Reduced Cardiovascular Events As Compared to Non-Pharmacological Intervention
A four-component polypill, including aspirin, atorvastatin, hydrochlorothiazide, and enalapril or valsartan, effectively reduced major cardiovascular events in a real-life setting study. The results of the PolyIran trial by Roshandel G. et al. was published in Lancet.
CLIMA Registry: OCT-Defined Plaque Morphology Links to Major Coronary Events CLIMA Registry: Presence of Multiple High Risk Plaque Features Detected By Optical Coherence Tomography Associated With Increased Risk of Cardiovascular Events
Data from CLIMA registry shows that simultaneous presence of four optical coherence tomography (OCT) plaque vulnerability features are associated with a seven-fold increased risk of future major coronary events. The study, led by Prati et al., is recently published in the European Heart Journal.
New Study Shows Elevated Levels of Troponin After Exercise Associated with Increased Rate of Cardiovascular Events
A study led by Dr. Vincent Aengevaeren, published in Circulation, showed that an elevated exercise-induced troponin I was associated with an increased risk of mortality and cardiovascular events in older long-distance workers. This may suggest that exercise-induced troponin elevations could be a marker of a future cardiovascular event and not a physiological response to exercise.
Novel Physiology-Based Method of Estimating Myocardial Ischemic Burden
Murai et al. devised a novel physiology-based method of estimating the amount of myocardium subtended by coronary stenosis, which is feasible and can be performed in the catheterization laboratory with a Doppler sensor-equipped guidewire. The study was published in the recent issue of Circulation: Cardiovascular Interventions.
Fractional Flow Reserve Aids Decision Making for Intermediate Coronary Lesions: 1-Month Data from FORZA Study
Compared with optical coherence tomography (OCT), fractional flow reserve (FFR) was associated with a higher percentage of medical therapy, lower risk of acute kidney injury, shorter hospital stay, and reduced costs at one month among patients with intermediate coronary lesions. The study by Leone et al., recently published in the Journal of American Heart Association, revealed.
PROMISE Trial: High-Sensitivity Troponins May Assist in Detecting Obstructive CAD in Symptomatic Outpatients
Increasing concentrations of hsTnI are significantly associated with the presence and severity of coronary artery disease (CAD) among stable outpatients with chest pain, an analysis of PROMISE trial indicates. The study, conducted by Prof. James Januzzi et al., is recently published in the June 1, 2019, issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.
TREAT Trial: No Difference in Recurrent Cardiovascular Events by 1 Year Between Ticagrelor and Clopidogrel in Patients with a STEMI Who Receive Fibrinolysis
A randomized controlled trial led by Dr. Otavio Berwanger published in JACC showed that in patients less than 75 with an ST-elevation myocardial infarction, administering ticagrelor as opposed to clopidogrel does not offer a reduced rate of recurrent cardiovascular events.
Latest Cross-Sectional Study Links Dietary Pattern Specific Protein Biomarkers to Development of Cardiovascular Disease
According to a nationwide cross-sectional study, protein biomarkers along with specific dietary patterns are linked to the development of cardiovascular disease (CVD). These findings, published in the Journal of the American Heart Association, suggest associations between dietary patterns and protein biomarkers have a role in the pathways related to inflammation, endothelial and immune function, cell adhesion and metabolism. Over the years, the role of diet in the prevention of CVD has been scientifically proven; unhealthy dietary components are important risk factors for the total global burden of this comorbidity. Continue reading
BIO-RESORT TRIAL: Lower Stent Strut Thickness Associated with Lower Rates of Repeat Revascularization
A prespecified analysis of the BIO-RESORT trial demonstrated that patients stent in small coronary vessels were less likely to need repeat revascularization if ultrathin-strut sirolimus-eluting stents were used as compared to the previous generation thin strut zotarolimus-eluting stent. Dr. Rosaly Buiten, the lead authors of this study published in JAMA cardiology, highlights the need to further evaluate the potential benefit of thin stent struts.
REVELATION: Drug-Coated Balloon Is Non-Inferior to Drug-Eluting Stent in Terms of Functional Outcome by 9 Months In Patients with STEMI
A randomized controlled trial led by Dr. Nicola Vos published in JACC: Cardiovascular Interventions showed that a treatment strategy involving the use of a drug-coated balloon (DCB) was non-inferior to drug-eluting stents (DES) for patients with ST-elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI). The data here suggest that using DCB could be both safe and feasible.
COMPASS: Treatment Benefit of Combined Low Dose Rivaroxaban and Aspirin Preserved in Patients with Moderate Renal Impairment
A secondary analysis of the COMPASS trial showed that the benefit of combining rivaroxaban 2.5mg twice daily and aspirin is preserved in patients with moderate renal dysfunction. Dr. Keith A.A. Fox demonstrated in the study published in the Journal of the American College of Cardiology that these patients did not have an excess risk of bleeding.
