- Trials for those with heart failure with preserved ejection fraction have not previously demonstrated significant evidence of benefit to date
- The use of the SGLT1/2 inhibitor, sotagliflozin, results in consistent, significant benefit in those with diabetes and reduced, midrange, and preserved ejection fraction
A restrictive transfusion strategy may no longer be inferior to a liberal transfusion strategy in preventing one-year MACE rates in acute MI and anemia patients, results of a REALITY study analysis presented at the 70th annual meeting of the American College of Cardiology (ACC), found. Continue reading
- This is the first study to assess the effects of Sacubitril/Valsartan in patients with advanced heart failure with reduced ejection fraction.
- No difference was found between Valsartan and Sacubitril/Valsartan when assessing the change in NT-proBNP levels from baseline in this sicker population.
- The two drugs had similar efficacy and tolerability profiles, with the exception of higher rates of hyperkalemia in the Sacubitril/Valsartan arm.
- Among patients with suspected acute coronary syndromes (ACS) and ischemia excluded on an initial electrocardiogram, randomized allocation of unmasked hs-cTnT within a 0/1-hour protocol as opposed to a 0/3-hour protocol with troponin T results masked at <29 ng/L was associated with:
- Reduction in functional stress testing
- Increase in coronary angiography and revascularization
- Unmasked reporting of hs-cTnT was not associated with a reduction in late death or myocardial infarction (MI) over 12 months of follow up
- Among those presenting with troponins within the masked range (≤29 ng/L), a significant increase in death or MI emerged within 12 months of follow up
INSPIRATION-S led by Behnood Bikdeli, MD, MS, and presented at the American College of Cardiology 2021 Meeting, failed to show the efficacy of atorvastatin in reducing thrombotic events and all-cause mortality. According to the presenter, the subgroup analysis demonstrated some hypothesis-generating signals that need to be further investigated in future research.
ACTION presented at the American College of Cardiology 2021 meeting by Renato D. Lopes, MD, PhD, demonstrated that among patients hospitalized with COVID-19 and elevated D-dimer levels, therapeutic anticoagulation with full-dose anticoagulant did not improve clinical outcomes and increased bleeding compared with prophylactic dose anticoagulation. Continue reading
Paclitaxel-coated balloons had come under fire in recent years, after a meta-analysis of randomized control trials involving their use for the treatment of peripheral artery disease found an associated with higher mortality when compared to non-drug coated devices. The study led to a letter of caution published by the FDA, leading to hesitance on the part of both physicians and patients to use the devices ever since. In June of 2019, the FDA called for additional long-term safety data to allow Paclitaxel-coated balloons to remain on the market. Continue reading
- While FFR-guided PCI is superior in chronic coronary syndrome, its role in primary PCI of acute coronary syndrome remained unknown.
- Patients with STEMI and multivessel disease, were randomized to undergo FFR-guided PCI versus angiography-guided PCI of non-culprit lesions after treatment of the culprit.
- There was no difference in MACE at one year between the two intervention arms at one year.
- Clopidogrel is superior to aspirin as chronic maintenance therapy after drug eluting stent (DES) placement with contemporary percutaneous coronary intervention (PCI) following 12 ± 6 months of dual antiplatelet therapy (DAPT)
- Specifically, those on Clopidogrel had a reduction in the composite endpoint of myocardial infarction, stroke, readmission for ACS as well was the secondary endpoints of thrombotic and bleeding events
Presented by Dr. Schuyler Jones, assistant professor of medicine, Duke University, and a member of the Duke Clinical Research Institute in the first Late Breaking Clinical Trial session, “Aspirin Dosing: A patient-centric Trial Assessing the Benefits and Long-term Effectiveness (ADAPTABLE)” asked a key question that many patients and physicians, PAs, and NPs face every day: Is 81 mg or 325 mg of aspirin more effective for secondary prevention for patients with pre-existing or established cardiovascular disease?
- Elderly frail patients with acute decompensated heart failure hospitalizations benefit from cardiac rehabilitation
- Tailored rehabilitation led to a large, significant improvement in Short Physical Performance Battery (SPPB) score which was relatively uniform across pre-specified subgroups
- Rehabilitation intervention patients saw large, significant, clinically meaningful improvements in 6-minute walk distance, quality-of-life, Fried Frailty score, and depression
With the widespread use of second-generation drug eluting stents, it has become more apparent that the risk of stent thrombosis decreases significantly after the first thirty days. The risk of bleeding, on the other hand, increases during that same time period. It has been proposed that de-escalation of potent P2Y12 inhibitors could mitigate that risk of bleeding. Dr. Kiyuk Chang and his co-investigators sought to answer this in the TALOS-AMI trial, the results of which were presented during a late breaking clinical trial session today at the 2021 American College of Cardiology Scientific Sessions. Continue reading
While renal denervation has been shown to improve blood pressure in patients with moderate hypertension, its effects on resistant hypertension have been more modest. During Sunday’s Late Breaking Clinical Trials session of the American College of Cardiology’s 2021 Scientific Sessions, Dr. Ajay Kirtane of Columbia University, presented the findings of the anticipated RADIANCE-HTN TRIO Trial, seeking to shine a light on the previously nebulous data. Continue reading
- There is not enough evidence to state whether Omega-3 Fatty Acid levels are beneficial or harmful against major adverse cardiovascular events in patients with high cardiovascular risk.
Dr. Steven E. Nissen is the chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. Prior to summarizing Dr. Nissen’s late breaking trial at presented May 16, Day 2 of ACC 2021 that is concurrently published in JAMA Cardiology . Continue reading
New results were presented from the Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy (PRADA) trial at ACC 2021 on May 16 and published concurrently in Circulation . The authors found that medications administered in addition to surgery, adjuvant breast cancer (BC) therapy with anthracylines with or without anti-human epidermal growth factor receptor 2 (HER2) therapy, and radiotherapy may not significantly attenuate the reduction in left ventricular ejection fraction (LVEF), nor improve cardiac troponins in early-stage BC patients.
Adjuvant breast cancer therapy, while beneficial in prolonging survival, has been shown to have harmful effects on the heart, prompting some providers to prescribe neurohormonal blocking agents to attenuate the myocardial damage. The original PRADA trial showed that candesartan and metoprolol helped prevent a decline in LVEF in patients on adjuvant therapy. To date, however, smaller studies have not shown a similar benefit to neurohormonal blockade. In a late breaking clinical trial session on May 16 at the 2021 American College of Cardiology Scientific Sessions meeting, Dr. Siri Lagethon Heck of Akershush University Hospital in Oslo, Norway, presented the long-term follow up results of the PRADA trial. Continue reading
Women fared worse than men in terms of increased bleeding risk, but comparable to men for ischemic event rates, results of a subgroup analysis of the TWILIGHT study presented May 15 at the 70th annual meeting of the American College of Cardiology (ACC) found. However, benefits of early aspirin withdrawal and continued use of ticagrelor in this high-risk PCI population was found to be comparable between sexes. Continue reading
Rivaroxaban should be considered as adjunctive therapy to aspirin alone in patients undergoing peripheral limb revascularization, authors of the VOYAGER-PAD trial concluded today. In the Late Breaking Clinical Trials session earlier today at the 2021 American College of Cardiology Scientific Sessions, Dr. Rupert Bauersachs of Darmstadt, Germany, presented the anticipated results of the trial, which attempted to answer whether post-intervention rivaroxaban could prevent future limb ischemia and need for repeat revascularization.
SGLT-2 inhibitors have demonstrated efficacy in various cardiometabolic conditions, including heart failure, coronary artery disease, chronic kidney disease, and diabetes. Given its favorable profile in various disease states, and the lack of effective therapies for patients hospitalized with COVID-19, it was hypothesized that dapagliflozin could provide organ protection in patients with cardiometabolic risk factors and COVID-19. During today’s Late Breaking Clinical Trials Session at the American College of Cardiology 2021 Scientific Sessions meeting, Dr. Mikhail Kosiborod of Saint Luke’s Mid Americas Hospital system presenting the findings of DARE-19, Dapagliflozin in Respiratory Failure in patients with COVID-19.
Transcatheter tricuspid valve replacement has become a feasible alternative to surgery in patients deemed to be at high risk of adverse events, and in the past decade, various devices have been designed to meet this clinical need. In his Focused Clinical Research session on the opening day of the American College of Cardiology 2021 Scientific Sessions, Dr. Susheel Kodali, director of the Structural Heart & Valve Center at New York-Presbyterian/ Columbia University Medical Center presented the 30-day results from the implantation of the EVOQUE valve, as part of the TRISCEND study. Continue reading