Science News from ESC 2020

EMPEROR-Reduced

Empagliflozin in heart failure with a reduced ejection fraction, with and without diabetes
Milton Packer | Baylor College of Medicine, Dallas, TX

RESULTS: Empagliflozin reduced the risk of CV death or hospitalization in patients with HFrEF whether or not they have diabetes. When combined with results from DAPA-HF, findings support the addition of SGLT2 inhibitors to recommended treatments for HFrEF. 

EXPLORER-HCM

Efficacy and safety of mavacamten in adults with symptomatic obstructive hypertrophic cardiomyopathy
Iacopo Oilivotto | Careggi University Hospital, Florence, Italy

RESULTS: Mavacamten, a first-in-class cardiac myosin inhibitor, improved heart function and symptoms in patients with obstructive hypertrophic cardiomyopathy. Every aspect of objective performance and subjective well-being improved on treatment, with high statistical significance, vs. placebo. 

Also published by AHA on Saturday

Colchicine in Patients with Acute Coronary Syndrome: The Australian COPS Randomized Clinical Trial
David C. Tong, et al.
Circulation, August  29, 2020

Initial Invasive versus Conservative Management of Stable Ischemic Heart Disease Patients with a History of Heart Failure or Left Ventricular Dysfunction: Insights from the ISCHEMIA Trial
Renado D. Lopes, et al
Circulation, August 29, 2020

EAST-AFNET 4

Effects of early rhythm control therapy in patients with atrial fibrillation
Paulus Kirchhof | University Heart and Vascular Center UKE, Hamburg, Germany

RESULTS: Early rhythm control therapy, when compared to usual care, was beneficial for patients newly diagnosed with atrial fibrillation (AF) and overall safety was comparable.

ATPCI

Trimetazidine in Angina Patients with Recent Successful Percutaneous Coronary Intervention: a Randomized, Double-Blind, Placebo-Controlled Trial
Roberto Ferrari | University of Ferrara, Ferrara, Italy

RESULTS: Among patients with chronic or acute coronary syndromes who had a recent successful PCI, trimetazidine after PCI did not improve outcomes.

POPULAR TAVI

Aspirin With or Without Clopidogrel after Transcatheter Aortic Valve Implantation
Jorn Brouwer | St. Antonius Hospital, Nieuwegein, The Netherlands

RESULTS: After TAVI, aspirin alone was superior to aspirin plus clopidogrel with respect to bleeding and thromboembolic events in patients not on oral anticoagulation and who had not had coronary stenting.

PARALLAX

Sacubitril/Valsartan versus Individualized RAAS Blockade in Patients with HFpEF
Burkert Pieske | Deutsches Herzzentrum Berlin, Berlin, Germany

RESULTS: In this trial of therapies for patients with HFpEF, sacubitril/valsartan significantly lowered NT-proBNP, but did not meaningfully improve functional capacity compared to optimal medical therapy.

DAPA-CKD

Dapagliflozin in Patients with Chronic Kidney Disease
Hiddo Heerspink | University of Groningen, Groningen, The Netherlands

RESULTS: In chronic kidney disease patients with or without T2DM, dapagliflozin reduced the risk of kidney failure, death from CV causes, HF hospitalization, and all-cause mortality.  

Also published by AHA on Sunday

Renal and Cardiovascular Effects of SGLT2 Inhibition in Combination with Loop Diuretics in Patients with Type 2 Diabetes and Chronic Heart Failure: The RECEDE-CHF Trial
Natalie A. Mordi, Ify R. Mordi, Jagdeep S. Singh, Rory J. McCrimmon, Allan D. Struthers, and Chim C. Lang
Circulation, August 30, 2020

LoDoCo2

Colchicine in Patients With Chronic Coronary Disease
Mark Nidorf | GenesisCare, Perth, Australia

RESULTS: In patients with chronic coronary disease, colchicine significantly lowers the risk of major CV events.  The reduction, almost one third, was observed rapidly after starting therapy, maintained over time, and is consistent in magnitude with the CANTOS and COLCOT trial findings.

BPLTTC

Blood Pressure Lowering for Prevention of Cardiovascular Events across Different Levels of Blood Pressure
Kazem Rahimi | University of Oxford, Oxford, UK

RESULTS: Blood pressure medication can benefit anyone with an elevated risk of having a heart attack or stroke, not only those with prior CVD or current hypertension.

IMPACT-AFib

Implementation of Stroke Prevention in Atrial Fibrillation
Sean Pokorney | Duke University, Durham, NC

RESULTS: When patients with atrial fibrillation and their healthcare providers received a single mailing describing oral anticoagulant medication benefits, medication use did not increase over one year. More research is needed to assess whether multiple education interventions would have been beneficial.

BRACE CORONA

Continuing vs. Suspending ACE Inhibitors and ARBs in COVID-19
Renato Lopes | Duke University, Durham, NC

RESULTS: Patients taking angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) to control blood pressure or treat heart failure should continue taking those medications even if hospitalized with COVID-19.