Curt Diehm

REFERENCE: European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
CURT DIEHM, University of Heidelberg
Peripheral arterial disease (PAD) can be diagnosed easily by a test using the ankle brachial index (ABI) and its presence can indicate a high risk of myocardial infarction. Curt Diehm explained his findings to Derek Thorne, while Peter Goodwin got expert comment from Freek Verheugt.

Ian Graham

REFERENCE: 15:40 Sunday 2nd Sept CV Disease Prevention, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
IAN GRAHAM, Trinity College, Dublin
Three key modifiable factors determine cardiovascular risk: blood pressure, lipid profile and smoking. That’s according to Ian Graham who summarized the latest European Society of Cardiology guidelines for preventing heart disease. Other factoirs including the metabolic syndrome, gender, body mass index and activity levels generally also involve the three master factors, and there are big benefits to be gained from modifying each of the key factors singly even when a patient can’t change one or more of them. Peter Goodwin discussed the new guidelines with Professor Ian Graham during the cardiology conference in Vienna.

Petr Widimsky

Eckhart Fleck

REFERENCE: Hot Line II Monday 3rd Sept, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
PETR WIDIMSKY, Charles University, Prague
COMMENT: ECKART FLECK, Deutsches Herzzentrum Berlin
The ESC guideline suggesting all patients with chronic stable angina having coronary angiography should have clopidogrel pre-treatment is now being questioned following findings of the PRAGUE-8 Study, which randomized patients to receive the anti-platelet agent either non selectively before angiography, or selectively after angiography in those considered to need PCI. The PRAGUE investigators concluded that the ESC guideline was unjustified for the treatment of elective angiography in chronic stable angina, and that the previous practice of selective administration of clopidogrel should be resumed. Nicola Solomon talked with Petr Widimsky at the ESC Congress in Vienna. Derek Thorne heard comments on the findings from Eckart Fleck.

Hugh Tunstall-Pedoe

REFERENCE: Abstract 1075, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
HUGH TUNSTALL-PEDOE, University of Dundee
New data presented at the ESC congress suggests that social deprivation should be considered when considering a cardiac risk score – not just smoking, blood pressure, HDL and cholesterol. Derek Thorne got the details and implications from Hugh Tunstall-Pedoe of Dundee University.

Gerald Werner

REFERENCE: Abstract 925, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
GERALD WERNER, Klinikum Darmstadt, Germany
The ESC congress in Vienna heard that drug eluting stents are highly effective in chronically occluded arteries, when compared with bare metal stents. Derek Thorne got more on this German study from Gerald Werner, of Klinikum Darmstadt in Germany.

David Morrow

REFERENCE: Abstract 1027, Clinical Trial Update I, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
DAVID MORROW, Brigham and Women’s Hospital, Boston
Further data to support the use of enoxaparin has come out of the latest update from the ExTRACT-TIMI 25 study. It shows at 12 months follow up, that the benefits of enoxaparin are durable and still superior to unfractionated heparin for patients with ST elevation myocardial infarction undergoing fibrinolytic therapy. Sarah Maxwell interviewed David Morrow at the Vienna meeting.

John Cleland

Maarten Simoons

REFERENCE: Hot Line 1 Sunday 11:00 2 Sept, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
JOHN CLELAND, University of Hull
COMMENT: MAARTEN SIMOONS, Erasmus University, Rotterdam
A new blood test using brain natriuretic peptide or BNP could become the primary step for diagnosing heart failure. This is according to the latest results from the Perindopril for Elderly People with Chronic Heart Failure or PEP-CHF study that measured levels of BNP in heart failure patients who had previously had echocardiograms. It found that many patients had been misdiagnosed. These results suggest that the BNP test should go before the echocardiogram for diagnosing patients with heart failure. Sarah Maxwell discussed the findings with study author John Cleland at the ESC meeting in Vienna.
Maarten Simoons of Erasmus University in Rotterdam commented on the PEP study findings.

Carlo Di Mario

Eckhart Fleck

REFERENCE: Hot Line II, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
CARLO DI MARIO, Royal Brompton Hospital, London
COMMENT: ECKART FLECK, Deutsches Herzzentrum Berlin
The CARESS study from Milan and London has shown that for younger, high-risk patients experiencing a myocardial infarction there can be a clear benefit from performing angioplasty as soon as it is available after using lytics with anti-platelet therapy in situations where primary angioplasty is not available. This answers a huge un-met need of what is best to do for patients who are admitted initially to a centre where primary percutaneous intervention is not an immediate option. At the cardiology congress in Vienna Carlo Di Mario told Peter Goodwin that patients at lower risk of bleeding who can proceed to angioplasty should do so.
Eckhart Fleck added his comments about following lytic therapy with angioplasty.

Stefan James

Raymond Gibbons

REFERENCE: Hot Line 1 Sunday 11:00 2 Sept, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
STEFAN JAMES, Uppsala Clinical Research Centre, Sweden
COMMENT: RAYMOND GIBBONS, Mayo Clinic, Rochester MN
Another year’s results of the long term outcome of using drug-eluting stents as compared with bare-metal stents from Sweden reveal that there is no longer an increased risk of late mortality when using drug-eluting stents according to Stefan James of Uppsala Clinical Research Centre. He suggested that improvements in technique have helped reduce the risk of death or myocardial infarction associated with using drug-eluting stents nevertheless the risk of blood clots still remains. Overall survival of patients was found to be the similar for both categories of stent.
Nicola Soloman interviewed Stefan James after his presentation at the European Society of Cardiology meeting in Vienna. Raymond Gibbons, president of the American Heart Association, added his comments.

Stephen MacMahon

Raymond Gibbons

REFERENCE: Abstract 312 Hot Line 1 Sunday, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria
STEPHEN MACMAHON, The George Institute, University of Sydney
COMMENT: RAYMOND GIBBONS, Mayo Clinic, Rochester MN
The randomised placebo controlled ADVANCE study of 11000 patients with diabetes has demonstrated that a combination of the ACE inhibitor, perindopril, with the diuretic indapamide can lower blood pressure and mortality. The investigators saw an impact even in patients who did not have high blood pressure. Lead study author Stephen MacMahon said this approach should be included in current practice guidelines. Sarah Maxwell spoke with him at the meeting in Vienna.
Raymond Gibbons commented on Stephen MacMahon’s presentation of the ADVANCE study.

David Wood