Science News from ACC.18

March 10–12, 2018 | Orlando, Florida
This is where you'll find results and expert insight on the most important science presented at ACC.18 in Orlando, Florida

Science presented Saturday, March 10

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Patrick O'Gara, MD, panelist for the ODYSSEY trial at ACC.18 discusses the results in the context of the FOURIER trial and what they might mean for patients and clinical practice going forward.

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Gregory G. Schwartz, MD, Phd, Co-Chair of the Executive Steering Committee for ODYSSEY, summarizes the results of the trial.

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Paul Wang, MD, Editor-in-Chief of Circulation: Arrhythmia and Electrophysiology interviews Byron Lee, MD, co-primary investigator for VEST.

ODYSSEY Outcomes: Cardiovascular Outcomes with Alirocumab After Acute Coronary Syndrome
Philippe Steg | Hôpital Bichat, Paris, France

VEST: Efficacy of a Wearable Cardioverter-Defibrillator after Myocardial Infarction: Results of the Vest Prevention of Early Sudden Death Trial
Jeffrey E. Olgin | University of California San Francisco, San Francisco, CA

Other science published Saturday in Circulation

Science presented Sunday, March 11

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Primary Investigator Tracy Wang, MD, MHS, MSc provides an overview of the ARTEMIS trial, which looked at the efficacy of interventions to improve adherence to anticoagulation medication post-MI.

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Mandeep R. Mehra, MD summarizes the results of MOMENTUM 3, which indicates a technological advance for the next generation of left ventricular assist devices.

ARTEMIS: Impact of Patient Copayment Reduction on P2Y12Inhibitor Persistence and Clinical Outcomes after Myocardial Infarction: The Affordability and Real-world Antiplatelet Treatment Effectiveness after Myocardial Infarction Study (ARTEMIS) Randomized Trial
Tracy Wang | Duke Clinical Research Institute, Durham, NC

PHARMCLO: A Prospective, Randomised, Multicentre Study Of A Pharmacogenomic Approach To The Selection Of Antiplatelet Therapy In Acute Coronary Syndromes
Diego Ardissino | Universitaria di Parma, Parma, Italy

TREAT: A Phase III, Randomized, International, Multicenter, Open label, with Blinded Adjudication of Outcomes, Non-Inferiority Clinical Trial to Explore the Safety and Efficacy of Ticagrelor Compared with Clopidogrel in Patients with Acute Coronary Syndrome with ST Elevation Treated with Thrombolysis
Otavio Berwanger | Research Institute HCor, Sao Paulo, Brazil

MANAGE: The Effect of Dabigatran in Patients Suffering Myocardial Injury After Noncardiac Surgery
P.J. Devereaux | Population Health Research Institute, Hamilton, Canada

  • RESULTS: In myocardial injury after noncardiac surgery (MINS), the use of dabigatran reduced the risk for major cardiovascular complications compared to placebo.
  • MANAGE Abstract (opens in new window)

SECURE-PCI Trial: Loading Doses of Atorvastatin versus Placebo in Patients with Acute Coronary Syndromes and Planned Revascularization
Otavio Berwanger | Research Institute HCOR, Sao Paulo, Brazil

MOMENTUM 3 - Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 - Long Term Outcomes
Joseph C. Cleveland | Brigham and Women's Hospital Heart and Vascular Center, Boston, MA

Inorganic Nitrite Delivery to Improve Exercise Capacity in Heart Failure with Preserved Ejection Fraction: The INDIE Trial
Barry Borlaug | Mayo Clinic, Rochester, MN

  • RESULTS: Inhaled nitrate therapy for HF with preserved ejection fraction (HFpEF) was not effective in improving exercise capacity or other clinical status measures.
  • INDIE Abstract (opens in new window)

Carvedilol for Prevention of Chemotherapy-Induced Cardiotoxicity - Results of the Prospective, Randomized, Double Blind, Placebo-Controlled Ceccy Trial
Monica Avila | Heart Institute (InCor) Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

  • RESULTS: At 6 months of f/u, heart function decline with anthracycline chemotherapy for breast cancer was not different when carvedilol was added. Markers for cardiotoxicity suggest possible protection from cardiac damage.
  • Ceccy Abstract (opens in new window)

Lisinopril or Carvedilol for Prevention of Trastuzumab Induced Cardiotoxicity
Maya E. Guglin/ University of Kentucky, Lexington, KY

  • RESULTS: For HER2+ breast cancer taking trastuzumab, the addition of lisinopril, an ACE-inhibitor, or carvedilol, a beta blocker, did not lessen cardiotoxicity. Cardioprotection was seen when added to anthracycline + trastuzumab chemotherapy.
  • Guglin's Abstract (opens in new window)

Science presented Monday, March 12

CARES: Primary Results of the Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Comorbidities
William B. White | University of Connecticut School of Medicine, Farmington, CT

Anti-Inflammatory Therapy with Canakinumab and Incident Type 2 Diabetes: A Pre-Specified Key Secondary Endpoint of the CANTOS Trial
Brendan Everett | Brigham and Women's Hospital, Boston, MA

  • RESULTS: Canakinumab, an anti-inflammatory drug, compared to placebo did not alter the rate of progression from prediabetes to diabetes but did show the same reduction in rates of major CV events as non-diabetic study patients.
  • CANTOS Abstract (opens in new window)

Blood Pressure Reduction in Black Barbershops
Ronald G. Victor | Cedars-Sinai Medical Center, Los Angeles, CA

TRIUMPH: A Pragmatic Trial of Low-dose Triple-Combination Blood Pressure Lowering Pill for Initial Treatment of Hypertension
Ruth Webster | The George Institute for Global Health, Sydney, Australia

  • RESULTS: In patients on no medication or on only 1 drug, a low-dose, triple combination BP pill compared to usual care lowered BP at 6 months without significant increases in side effects.
  • TRIUMPH Abstract (opens in new window)

POISE: 1-Year Outcomes of Perioperative Beta-blockade in Patients Undergoing Noncardiac Surgery
P.J. Devereaux | Population Health Research Institute, Hamilton, Canada

STOP-PAD: A Phase II Randomized Double-Blind, Placebo Controlled Study in Patients with Critical Limb Ischemia to Evaluate the Safety and Efficacy of hSDF-1 plasmid (JVS-100) Post Open or Endovascular Revascularization to Enhance Wound Healing
Mehdi H. Shishehbor | University Hospitals, Cleveland, OH

  • RESULTS: At 3 months, use of JVS-100 in addition to revascularization did not improve wound healing compared to placebo for patients with critical limb ischemia.
  • Shishehbor Abstract (opens in new window)

Device Closure Versus Medical Therapy for Secondary Prevention in Cryptogenic Stroke Patients with High-Risk Patent Foramen Ovale
Jae-Kwan Song | Asan Medical Center, Seoul, South Korea

  • RESULTS: Patent foramen ovale (PFO) device closure compared to standard medical treatment for secondary prevention after a cryptogenic stroke improved clinical outcomes at 2 years. Optimal candidate selection considered vital to appropriate device use.
  • Song Abstract (opens in new window)

SMART-DATE: Safety of 6-Month Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients with Acute Coronary Syndromes
Hyeon Cheol Gwon | Samsung Medical Center, Seoul, South Korea

  • RESULTS: MI risk was increased for the 6-month DAPT, although 6 months of dual antiplatelet therapy (DAPT) after PCI with drug-eluting stent placement in ACS patients was determined to be non-inferior to 12 months of DAPT for MACCE at 18 months.
  • SMART-DATE Abstract (opens in new window)

Interim Report on the ANNEXA-4 Study: Andexanet For Reversal of Anticoagulation in Factor Xa - Associated Acute Major Bleeding
Stuart Connolly | Population Health Research Institute, McMaster University, Hamilton, Canada

  • RESULTS: Interim analysis results from this ongoing clinical trial suggest safety (death, stroke, MI, peripheral thrombus) and efficacy (reduction in anti-Factor Xa inhibitor activity, clinical hemostasis) in reversing major bleeding while taking a Factor Xa inhibitor.
  • ANNEXA-4 data summary slide (PDF)