Cardiovascular

This category contains 98 posts

Bivalirudin For Angioplasty: Expensive Heparin?

Tony Gershlick
Tony Gershlick

Tony Gershlick, University of Leicester
Adnan Kastrati, Deutsches Herzzentrum, Munich
Using bivalirudin instead of heparin during angioplasty wasn’t any better for preventing death, MI or urgent revascularisation in the 4,500-patient ISAR-REACT 3 study presented at the ACC annual meeting. Tony Gershlick and Adnan Kastrati discuss the study with Peter Goodwin and Sara Freeman.

Remove Thrombus Before Primary Angioplasty!

Felix Zijlstra
Felix Zijlstra

Felix Zijlstra, University Medical Center Groningen, The Netherlands
Thrombus aspiration before percutaneous coronary intervention for acute myocardial infarction has multiple benefits, according to data from the 1000-patient TAPAS study presented at the ACC meeting. Senior investigator Felix Zijlstra told Sara Freeman about the potentially practice-changing findings.

Heart Failure Drug Prevents Renal Damage?

Barry Massie
Barry Massie

Barry Massie, San Francisco VA Medical Center
COMMENT: Aaron Kugelmass, Henry Ford Hospital, Detroit
The adenosine A1-receptor antagonist rolofylline appears to prevent renal impairment and improve acute heart failure symptoms. Barry Massie and Aaron Kugelmass discussed findings from the 300-patient PROTECT pilot study with Sara Freeman.

Never Too Old For Hypertension Treatment!

Nigel Beckett
Nigel Beckett
Nick Boon
Nick Boon

Nigel Beckett, Imperial College, London
COMMENT: Nick Boon, British Cardiovascular Society, London

Even very old patients benefit greatly if you treat their hypertension. This is the finding of the randomized HYVET study of 4,000 patients with average age 83. Peter Goodwin talked with investigator Nigel Beckett, who presented details at one of the ACC sessions, and from the chairperson and British Cardiovascular Society President, Nick Boon who added his comments.

Routine Angioplasty Recommended After Thrombolysis

Warren Cantor
Warren Cantor
Tony Gershlick
Tony Gershlick

REFERENCE: Abstract 2404-3 SCAI-ACCi2 Late-Breaking Clinical Trials II: Acute Myocardial Infarction
Warren Cantor, University of Toronto
COMMENT: Tony Gershlick, Leicester University

A new study has shown important gains from adding angioplasty routinely to therapy for all patients receiving thrombolysis for acute myocardial infarction if it is available within 6 hours. This comes from the 1 000-patient TRANSFER-AMI study which Warren Cantor presented to the ACC. He talked with Peter Goodwin who also discussed the findings with Tony Gershlick.

Protective Cardiovascular Benefit for Women on HRT For Natural Menopause

George Sopko
George Sopko

REFERENCE: Abstract 3771, American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida
N Engl J Med 2007;357

GEORGE SOPKO, National Heart, Lung And Blood Institute, Bethesda, Maryland
COMMENT: JENNIFER MIERES, New York University

A new study presented to the American Heart Association meeting found women taking hormone replacement therapy since the menopause had a protective cardiovascular benefit. This was greater the earlier HRT was initiated and the women who took HRT had lower rates of coronary artery disease. Chief study author George Sopko spoke with Sarah Maxwell at the Orlando meeting.

Oral Contraceptive Use: More Carotid and Femoral Atheroschlerosis Later in Life

Ernst Rietzschel
Ernst Rietzschel
Jennifer Mieres
Jennifer Mieres

REFERENCE: News Briefing, American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida
N Engl J Med 2007;357

ERNST RIETZSCHEL, University of Ghent, Belgium
COMMENT: JENNIFER MIERES, New York University

Women who used the contraceptive pill had increases in atherosclerotic plaque in their carotid and femoral arteries of between 20 and 30 percent by the time they reached late middle age. This is the finding of the ASKLEPIOS study conducted by the University of Ghent in which plaque was measured by ultrasound in 2 500 healthy men and women. Ernst Rietzschel presented data from the study to the 2007 Sessions of the AHA, and afterwards discussed the findings with Peter Goodwin.

TAXUS DES Trials Results: How Long Should Thienopyridine Be Used After Drug Eluting Stent?

Gregg Stone
Gregg Stone
REFERENCE: Abstract 2357, American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida
GREGG STONE, Columbia University, New York
New light has been thrown on the use of thienopyridine therapy after percutaneous intervention using drug-eluting stents. Gregg Stone presented data from the TAXUS DES trials which looked at patients surviving more than a year after receiving either paclitaxel-eluting or bare metal stents. After his talk at the American Heart Association he discussed his findings with Sarah Maxwell.

Torcetrapib in Patients at High Risk for Coronary Events: ILLUMINATE Trial Latest Results

Philip Barter
Philip Barter
Gordon Tomaselli
Gordon Tomaselli

REFERENCE: Late Breaking Clinical Trials, Session 2, American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida
N Engl J Med 2007;357

PHILIP BARTER, Heart Research Institute, Sydney, Australia
COMMENT: GORDON TOMASELLI, Johns Hopkins University, Baltimore

A randomized double-blind study involving over 15,000 patients at high cardiovascular risk which looked at the new agent torcetrapib (an inhibitor of cholesteryl ester transfer protein, CETP) resulted in higher mortality in the experimental arm. The study compared torcetrapib plus atorvastatin with atorvatstin alone. Inhibition of CETP increases HDL levels and reduces LDL levels and should combat atherosclerosis. Sarah Maxwell spoke with Philip Barter who presented data on the ILLUMINATE trial at the American Heart Association meeting in Orlando.

Rosuvastatin: No Significant Benefit for Older Patients with Systolic Heart Failure: CORONA Study Results

Ake Hjalmarson
Ake Hjalmarson
Gordon Tomaselli
Gordon Tomaselli

REFERENCE: Late Breaking Clinical Trials, Session 2, American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida
N Engl J Med 2007;357

AKE HJALMARSON, Sahlgrenska University, Göteborg
COMMENT: GORDON TOMASELLI, Johns Hopkins University, Baltimore

The lipid lowering agent rosuvastatin did not bring a significant benefit to older patients with systolic heart failure, according to the findings of the CORONA study released at the American Heart Association sessions in Orlando. Ake Hjalmarson talked with Peter Goodwin about the implications this has for using statins in older patients with heart failure.

Eptifibatide as Effective as Abciximab in Primary PCI for Acute ST Elevation Myocardial Infarction: EVA-AMI Study

Uwe Zeymer
Uwe Zeymer
REFERENCE: Late Breaking Clinical Trials Session I, American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida
UWE ZEYMER, Herzzentrum Ludwigshafen, Germany
The glycoprotein 2B 3A antagonist eptifibatide has performed as well as standard abciximab therapy in patients receiving primary angioplasty for acute myocardial infarction. So according to Uwe Zeymer who presented findings on this it can be used in this setting just as it is already being used in elective PCI. Sarah Maxwell interviewed Dr Zeymer at the Orlando conference.

TRITON-TIMI 38 Prasugrel Or Clopidogrel In Percutaneous Intevention?

Gordon Tomaselli
Gordon Tomaselli
Daniel Jones
Daniel Jones

REFERENCE: Late Breaking Clinical Trials 1, American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida
GORDON TOMASELLI, Johns Hopkins University, Baltimore
COMMENT: DANIEL JONES, President, American Heart Association, University of Mississippi, Jackson

A potential new option for patients with acute coronary syndromes receiving coronary intervention has emerged following a report on the comparison of prasugrel, a new anti-platelet agent, with clopidogrel. Elliott Antman from Brigham and Women’s Hospital in Boston gave the American Heart Association his findings and recommendations about when and in which patients prasugrel might be favored. Gordon Tomaselli discussed the findings with Sarah Maxwell.