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Audio Journal of Cardiovascular Medicine 10.3, May 2004
Reporting from:
European Society of Cardiology Congress, Munich, August 28-1 September, 2004
Scientific Editors:
Michael Petch, Papworth Hospital, Cambridge
Man Fai Shiu, Walsgrave Hospital, Coventry
James Tcheng, Duke University, Durham
Harvey White, Green Lane Hospital, Auckland
Producer: Derek Thorne
Correspondents: Richard Black, Graham Easton & Peter Goodwin
In this edition:
Philip Poole-Wilson has the latest results from the ACTION trial, which looked at the safety and efficacy of nifedipine in the treatment of angina. Michael Petch comments.
The cannabinoid receptor blocker rimonabant can help people with risk factors related to the metabolic syndrome that’s according to Alain Golay, who presented findings from the RIO-LIPIDS trial at the ESC annual congress in Munich.
Robert Kiss talks about a large prospective study from Hungary, which appears to show that aspirin resistance represents a higher risk of mortality among cardiovascular patients continuing to take aspirin for secondary prevention. Richard Conti gives his thoughts on the trial.
The ARTS trial, the largest study comparing bypass surgery to percutaneous intervention in patients with multi-vessel disease, is now five years old. Patrick Serruys describes the latest findings.
Philip Poole-Wilson, Royal Brompton Hospital, London
The ESC meeting saw the results of a major trial on the safety and efficacy of nifedipine in the treatment of angina. The ACTION trial enrolled eight thousand people with chronic angina, and randomised them to either placebo or the long-acting GITS formulation of nifedipine.
COMMENT: Michael Petch, Papworth Hospital, Cambridge
Robbert de Winter, University of Amsterdam
The early use of Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting in the majority of high risk unstable angina patients was not endorsed by a new trial from Amsterdam called ICTUS.
Marc Brouwer, University of Nijmegen
A meta-analysis from Nijmegen has produced similar findings to the ICTUS trial - that early invasive therapy may not always bring a better outcome in acute coronary syndromes.
Robert Kiss, University of Budapest
A large prospective study from Hungary appears to show that aspirin resistance represents a higher risk of mortality among cardiovascular patients continuing to take aspirin for secondary prevention.
COMMENT: Richard Conti, University of Florida, Gainesville
John McMurray, Western Infirmary, Glasgow
New data presented in Munich suggests that cardiologists may not be paying enough attention to glucose status in their patients. John McMurray says that it may now be time to consider checking glycaemic status in all patients with cardiovascular disease or even just risk factors.
Caroline Daly, Royal Brompton Hospital, London
In a session on intensive treatment for diabetes, delegates heard about a study that sheds some light on the impact of metabolic syndrome on patients with coronary disease.
COMMENT: Man Fai Shiu, Walsgrave Hospital, Coventry
Michael Petch, Papworth Hospital, Cambridge
One of the big studies presented at the Munich conference was the Interheart Study - a massive investigation of the risk factors for heart disease with some important clinical implications.
Alain Golay, University Hospital, Geneva
One option for helping people with risk factors related to the metabolic syndrome would appear to be the cannabinoid receptor blocker rimonabant. The RIO-LIPIDS investigated the effect of the drug in 1000 overweight or obese patients.
Chaime Lotan, Hadassah Hospital, Jerusalem
Drug-eluting stents have proved their worth in a number of lesion types but how effective are they in chronic total occlusion? Drawing on data from the e-CYPHER registry, researchers from Jerusalem have been aiming to find out.
Patrick Serruys, Erasmus University, Rotterdam
The ARTS trial, the largest study comparing bypass surgery to percutaneous intervention in patients with multi-vessel disease, is now five years old. It randomised around 1200 subjects eligible for either treatment, and in Munich, delegates heard the latest results.
Tony Barnett, Birmingham Heartlands Hospital
For the growing number of patients with type 2 diabetes, hypertension and early neuropathy, should physicians be using angiotensin converting enzyme inhibitors, or angiotensin receptor blockers? The 5-year DETAIL study provided the first comparative evidence, and suggests that an ARB, telmisartan, is equivalent to enalapril in providing renal protection in these patients.
Anselm Gitt, Heart Centre, Ludwigshafen
A number of studies in the last few years have indicated the primacy of primary PCI over thrombolysis. But there may be a reluctance to give this invasive procedure to elderly patients. According to data from a German registry, MITRA-plus, it’s well worthwhile.
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AJC
Audio Journal of Cardiovascular Medicine 10.3, May 2004
Reporting from:
European Society of Cardiology Congress, Munich, August 28-1 September, 2004
In this edition:
The RITA-3 trial - focussing on how to manage patients with acute coronary syndromes - reported 5-year data at this year’s ESC Congress. Keith Fox talked about new evidence that strengthens the case for aggressive management of patients.
The conference also heard the latest on the Endeavor stent, which elutes the sirolimus analogue ABT-578. Jean Fajadet from Toulouse discussed the ENDEAVOR-2 study.
A future option for treating in-stent restenosis by coating a balloon with an anti-proliferative drug and inflating it inside the newly-occluded stent was discussed at the ESC Congress by Bruno Scheller who presented the first study of such a device in humans.
In the treatment of acute myocardial infarction, the 24-country ASSENT-4 study seems to show an overall increase of risk if you use thrombolysis before primary PCI. Frans Van de Werf gave the 30 day analysis. Kim Fox comments.
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Phil Edwards, London School of Hyugiene and Tropical Medicine
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