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Audio Journal of Cardiovascular Medicine 10.3, May 2004

  • in Cardiovascular
  • — 8 Jan, 2006
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.

Interviews in this edition:

1. ACTION from Nifedipine in Angina

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

2. Early Invasive Strategy: Not For All Acute Coronary Syndrome Patients

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.

3. Meta Analysis: Long Term Mortality of Early Invasive Management of non-ST Elevation Acute Coronary Syndrome

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.

4. Aspirin Resistance: Higher Mortality Risk?

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

5. NAVIGATOR: Why Care about Glucose

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.

6. Metabolic Syndrome: Coronary Disease Risk Factor

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

7. Interheart Study: Implications for Cardiologists

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.

8. Cannabinoid Receptor-Blocker: Dyslipidaemia Treatment and Other Benefits

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.

9. Drug-eluting Stents: Equally Effective in Total Occlusion

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.

10. By-Pass or PCI? ARTS Paints Balanced Picture

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.

11. ARB or ACE Inhibitor for Renal Protection? The DETAIL study

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.

12. Primary PCI in the Elderly

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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