Science News from ACC.17
Selected science from Friday, March 17
FOURIER: Adding PCSK9 to Statin Therapy Reduces CV Events
Sidney C. Smith, Jr., MD, past president of the American Heart Association, comments on the results of the FOURIER trial. Watch Dr. Smith's take on the global impacts here.
FOURIER – Primary Results of the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) Trial
Marc Steven Sabatine | TIMI Study Group, Boston, MA
- RESULTS: Evolocumab added to statin therapy in high-risk patients lowered LDL-C and reduced cardiovascular events.
- FOURIER data summary slide (PDF)
- Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease (opens in new window)(link opens in new window) – simultaneous publication in NEJM
- Antidrug Antibodies in Patients Treated with Alirocumab (opens in new window)(link opens in new window) – correspondence published in NEJM
- VIDEO: Adding PCSK9 to statin therapy reduces CV events
- VIDEO: FOURIER delivers good news globally
SPIRE 1 and SPIRE 2 – Safety and Cardiovascular Event Efficacy of Bococizumab Among 27,000 High Risk Patients
Paul M. Ridker on behalf of the SPIRE Investigators | Brigham and Women's Hospital, Boston, MA
- RESULTS: Major cardiovascular events were reduced in higher risk patients but not in lower risk patients.
- SPIRE 1 & SPIRE 2 data summary slide (PDF)
- Lipid-Reduction Variability and Antidrug-Antibody Formation with Bococizumab (opens in new window) – simultaneous publication in NEJM
- Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients (opens in new window)(link opens in new window) – simultaneous publication in NEJM
- VIDEO: PCSK9 shows potential benefit for high-risk patients
SURTAVI Expands the Treatment Options Available for More Patients
John Warner, MD, president elect of the American Heart Association and Timothy J. Gardner, MD, past president, discuss the results of the SURTAVI trial and what they suggest for the care of patients at varying levels of risk going forward.
Be sure to visit AHA's Scientific Publications booth in the Expo Hall for products and publications designed to help busy cardiovascular professionals and researchers.
SURTAVI – Transcatheter Aortic Valve Replacement With a Self-Expanding Bioprosthesis Compared With Surgical Aortic Valve Replacement in Patients at Intermediate Surgical Risk: First Results From the SURTAVI Clinical Trial
Michael J. Reardon, on behalf of the SURTAVI investigators | Methodist DeBakey Heart and Vascular Center, Houston, TX
- RESULTS: For intermediate risk patients with severe aortic stenosis, TAVR was non-inferior to surgery for aortic valve replacement.
- SURTAVI data summary slide (PDF)
- Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients (opens in new window)(link opens in new window) – simultaneous publication in NEJM
- VIDEO: SURTAVI Expands the Treatment Options Available for More Patients (opens in new window)
- Journal article: Acute Changes in Left Atrial Pressure After MitraClip Are Associated With Improvement in 6-Minute Walk Distance (opens in new window)(link opens in new window) by Elad Maor, et. al
Circulation: Cardiovascular Interventions
- AHA News Article: Indigenous South American group has the world’s healthiest arteries (opens in new window)(link opens in new window)
- AHA News Article: Routine blood tests may help predict chronic disease risk (opens in new window) (link opens in new window)
- AHA News Article: Study: AFib patients may be able to stop blood thinners after ablation (opens in new window)(link opens in new window)
Selected science from Saturday, March 18
EINSTEIN CHOICE and GEMINI ACS 1
Mark Creager, MD, past president of the American Heart Association, and Elliott Antman, MD, also a past president, discuss the outcomes of EINSTEIN CHOICE and GEMINI-ACS-1, which compared rivaroxaban to aspirin in different clinical applications.
ABSORB III Results
John Warner, MD, president elect of the American Heart Association, reports on the results of the ABSORB III trial. See a data summary of the trial.
EINSTEIN-CHOICE – Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism
Philip S. Wells | Bayer AG, Wuppertal, Germany
- RESULTS: Rivaroxaban reduced the risk for recurrent symptomatic VTE more than aspirin.
- EINSTEIN CHOICE data summary slide (PDF)
- Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism (opens in new window)(link opens in new window) – simultaneous publication in NEJM
- VIDEO: Rivaroxaban vs. aspirin for VTE and after ACS (opens in new window)(link opens in new window)
GEMINI-ACS-1 – A Randomized Trial Evaluating Clinically Significant Bleeding With Low-Dose Rivaroxaban Versus Aspirin, in Addition to P2Y12 Inhibition, for Patients After Acute Coronary Syndromes
Erik Magnus Ohman | Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
- RESULTS: Bleeding not increased post ACS with rivaroxaban.
- GEMINI-ACS-1 data summary slide (PDF)
- VIDEO: Rivaroxaban vs. aspirin for VTE and after ACS (opens in new window)(link opens in new window)
CARAT – Effect of Serial Infusions of CER-001, a Pre-Beta High-Density Lipoprotein Mimetic on Coronary Atherosclerosis: Results of the CARAT Study
Stephen J. Nicholls | South Australian Health and Medical Research Institute, Adelaide, Australia
- RESULTS: Coronary artery plaque not reduced with synthetic HDL-C drug.
COMPARE-ACUTE – FFR Guided Acute Complete Revascularization Versus Culprit Lesion Only Treatment in Patients Presenting With ST-Segment Elevation Myocardial Infarction and Multi Vessel Disease
Pieter Smits for the COMPARE-ACUTE investigators | Department of Cardiology Maasstad Ziekenhuis, Rotterdam, The Netherlands
- RESULTS: Fewer composite cardiovascular events occurred with FFR-guided acute complete revascularization than treating only the infarcted artery.
- Fractional Flow Reserve–Guided Multivessel Angioplasty in Myocardial Infarction (opens in new window)(link opens in new window) – simultaneous publication in NEJM
DEFINE-FLAIR – Primary Results of DEFINE-FLAIR: A Multi-Centre, Prospective, International, Randomized, Blinded Comparison of Clinical Outcomes and Cost Efficiencies of iFR and FFR Decision-Making for Physiological Guided Coronary Revascularization
Justin E. Davies | Imperial College, London, United Kingdom
- RESULTS: Equivalent rates of adverse events seen for IFR AND FFR-guided revascularization.
- Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI (opens in new window) – simultaneous publication in NEJM
IFR-SWEDEHEART – Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve Guided Intervention (IFR-SWEDEHEART): A Multicenter, Prospective, Registry-Based Randomized Clinical Trial
Matthias Götberg | Department of Cardiology, Lund University, Lund, Sweden
- RESULTS: iFR- and FFR-guided revascularization had similar rates of major adverse events at 12 months.
- Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI (opens in new window)(link opens in new window) – simultaneous publication in NEJM
ABSORB III – Everolimus-Eluting Bioresorbable Vascular Scaffolds in Patients With Coronary Artery Disease: Two-Year Outcomes From the ABSORB III Trial
Stephen Ellis | Cleveland Clinic, Cleveland, OH
- RESULTS: 1- and 2-year outcomes similar for Absorb BVS and Xience; more adverse outcomes with BVS at 2 years.
- ABSORB III data summary slide (PDF)
- VIDEO: ABSORB III Results with John Warner, MD (opens in new window)(link opens in new window)
Selected science for Sunday, March 19
LEVO-CTS: Primary Outcomes for Cardiac Surgery with Levosimendan
Patrick O'Gara, MD, Brigham and Women's Hospital, provides context for the results of the LEVO-CTS trial.
LEVO-CTS – Levosimendan in Patients With Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery With Cardiopulmonary Bypass: Primary Results of the LEVO-CTS Trial
John H. Alexander | Duke Clinical Research Institute, Durham, NC
- RESULTS: Primary outcomes for cardiac surgery not better with levosimendan.
- LEVO-CTS data summary slide (PDF)
- Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery (opens in new window)(link opens in new window) – simultaneous publication in NEJM
- VIDEO: Patrick O'Gara, MD, provides context for the LEVO-CTS results (opens in new window)(link opens in new window)
VISION Study – Relationship Between High Sensitive Troponin T Measurements and 30-Day Mortality After Noncardiac Surgery
P.J. Devereaux, Population Health Research Institute, Hamilton, Canada
- RESULTS: Post-surgery high-sensitivity troponin levels after non-cardiac surgery may identify unrecognized heart damage.
- VISION data summary slide (PDF)
RESOLVE and SAVORY – Subclinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Aortic Valves: Results From RESOLVE and SAVORY Registries
Raj R. Makkar | Cedars-Sinai Heart Institute, Los Angeles, CA
- RESULTS: Subclinical leaflet thrombosis not uncommon with bioprosthetic aortic valves.
Cerebral Embolic Protection Devices During Surgical Aortic Valve Replacement: A Randomized Trial From the Cardiothoracic Surgical Trials Network
Michael Mack | For the CTSN Investigators, Icahn School of Medicine at Mount Sinai, New York, NY
- RESULTS: Number of cerebral infarcts not reduced with embolic protection devices.
RE-CIRCUIT – Safety and Efficacy of Uninterrupted Anticoagulation With Dabigatran Etexilate Versus Warfarin in Patients Undergoing Catheter Ablation of Atrial Fibrillation: The RE-CIRCUIT Study
Hugh Calkins on behalf of the RE-CIRCUIT Investigators | Boehringer Ingelheim, Ingelheim am Rhein, Germany
- RESULTS: Less bleeding events with uninterrupted dabigatran compared to uninterrupted warfarin for patients having catheter ablation for AF.
- Uninterrupted Dabigatran versus Warfarin for Ablation in Atrial Fibrillation (opens in new window)(link opens in new window) – simultaneous publication in NEJM
ARISTOTLE – Digoxin and Mortality in Patients With Atrial Fibrillation With and Without Heart Failure: Does Serum Digoxin Concentration Matter?
Renato D. Lopes | Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
- RESULTS: Digoxin in AF patients may increase the risk of mortality in a dose-dependent manner.
Comparative Effectiveness of Left Atrial Appendage Occlusion Among Atrial Fibrillation Patients Undergoing Cardiac Surgery: A Report From the Society of Thoracic Surgeons Adult Cardiac Surgery Database
Daniel J. Friedman | Washington University, St. Louis, MO
- RESULTS: Left atrial appendage occlusion in AF patients during cardiac surgery reduced the risk for thromboembolism.