REFERENCE: Abstract 1745
Shamir Mehta, McMaster University, Hamilton, Canada
Results in over 30 000 patients with acute coronary syndromes or ST elevation myocardial infarction in the OASIS 5 and OASIS 6 studies experienced better mortality, fewer events and less bleeding if their anticoagulation was with the factor 10a inhibitor fondaparinux. Shamir Mehta of McMaster University in Hamilton, Canada, presented results to the Barcelona cardiology congress of superior outcomes compared with other anticoagulation regimens.

REFERENCE: Abstracts 1739, 1741, 1743 and 1746
Keith Fox, Royal Infirmary, Edinburgh
Early invasive therapy for acute coronary syndromes was under the microscope at the conference in Barcelona. Keith Fox of Edinburgh University discussed the FRISC II study from Sweden which reported superiority for an early invasive strategy, and after his talk Peter Goodwin asked him about this and about the ICTUS trial from the Netherlands which failed to show an advantage.

REFERENCE: Abstract 1741
Petr Widimsky, Charles University, Prague
Even if patients with myocardial infarction have to be transported to a referral centre some hours away from their home they are still likely to benefit more from primary percutaneous intervention rather than thrombolyis. This is the conclusion after five years of follow up in the Prague II study reported at the Barcelona conference by Petr Widimsky of Charles University in Prague. Peter Goodwin asked him about the results.

REFERENCE: Abstract 3417
Gerrit Veen, VU University, Amsterdam
A check should be made for myocardial viability before going ahead with angioplasty after thrombolyis, according to the findings of the VIAMI (Viability-guided Angioplasty after Acute Myocardial Infarction study) from the Netherlands. Because thrombolyis is still the mainstay of treatment for MI around the world, the study looked at candidates for intervention after lysis and found that some patients do better with conservative therapy. Sarah Maxwell talked with Gerit Veen of VU University in Amsterdam.

REFERENCE: Abstract 986; Hot Line 1 Session
David Wood, Imperial College, London
A multi-disciplinary preventive cardiology programme directed by nurses has achieved superior results in patient compliance over and above usual care in either hospital or general practice. The EUROACTION study investigated the scope for improving on diet, smoking and exercise goals for high-risk coronary patient and others at risk of coronary disease. David Wood from London’s Imperial College presented findings from 10 000 patients at a “Hot Line” session of the Cardiology Congress. Afterwards he discussed the practical implications of the findings with Peter Goodwin.

REFERENCE: Abstract 122
Magnus Ohman, Duke University, Durham, North Carolina
Although atherosclerosis is often thought to be a western disease, conditions like coronary artery disase, cerebrovascular disease and peripheral arterial disease are prevalent and increasing in many other regions of the world, where insufficient action to avoid atherothrombotic disease has been taken. Magnus Ohman from Duke University told delegates in Barcelona about his findings from the REACH registry. He discussed the implications with Peter Goodwin.

REFERENCE: Abstract P4638
Kenneth Morgan, Royal Lancaster Infirmary
Primary angioplasty rather than thrombolyis should be given to patients diagnosed with myocardial infarction regardless of age, according to a new study from the UK. Kenneth Morgan presented his data showing that older patients, too, have better survival and a reduction of stroke if they have primary pci rather than thrombolyis. He talked about his findings with Sarah Maxwell, who also heard comments on the study from Philip Poole-Wilson.

REFERENCE: Abstract P4638
Philip Poole-Wilson, Imperial College, London

REFERENCE: Abstract 53, Page 85
Anthony Wierzbicki, St Thomas’s Hospital, London
The idea of adding nicotinic acid to lipid-lowering therapy for patients at high risk of coronary events – for either secondary or primary prevention – was discussed at the World Congress of Cardiology and the European Society of Cardiology Congress in Barcelona. At a special session entitled: “Beyond Statin Therapy” Anthony Wierzbicki told delegates about the THRIVE trial adding niacin to statin therapy. Peter Goodwin asked him about this and about the earlier studies: ARBITER and HATS which clearly demonstrated the importance of combining HDL-raising therapy along with LDL reduction.

REFERENCE: Abstract 93
Gabriel Steg, Hôpital Bichat, Paris
Mature findings on the use of the weight-loss drug, rimonabant, were presented to the 2006 meeting of the European Society of Cardiology held in Barcelona. Sarah Maxwell asked Gabriel Steg first about why rimonabant was considered scientifically as a candidate for appetite reduction, and how effective it has proved in the recent RIO series of studies.

REFERENCE: Abstract 11
David Paquette, University of North Carolina, Chapel Hill
The idea that inflammation caused by infectious pathogens can cause a significant burden of cardiovascular disease was explored in a symposium at the cardiology congress which looked at periodontal inflammation and its correlation with coronary disease. David Paquette from the University of North Carolina in Chapel Hill presented provocative evidence of possible cause and effect which he discussed with Sarah Maxwell.