From Doctors Lounge

Cardiology Conference Briefing
2007 - American College of Cardiology - 56th Annual Scientific Session
By American College of Cardiology
Mar 25, 2007 - 10:28:52 PM

The American College of Cardiology - 56th Annual Meeting was held in New Orleans, March 24-27, 2007. The scientific session includes the 2nd Annual Innovation in Intervention: i2 Summit. The following is a briefing of some of the articles presented at the conference.

Stem cell therapy shows promise in regenerating damaged muscle in heart attack patients
Heart attack patients who received an new intravenous adult stem cell therapy, Provacel, experienced a lower number of adverse events, such as cardiac arrhythmias, and had significant improvements in heart, lung and global function compared to those who received a placebo, according to six-month Phase I study data presented at the American College of Cardiology's Innovation in Intervention: i2 Summit in New Orleans on March 25.

Study finds coronary procedure adds no benefit over 'optimal medical therapy' alone
Percutaneous coronary intervention plus optimal medical therapy does not improve outcomes in patients with coronary artery disease, compared with optimal medical therapy alone, according to study results presented yesterday at the 56th Annual Scientific Session of the American College of Cardiology in New Orleans, and published online in the New England Journal of Medicine.

Gene test shown to measure heart function after transplant
New Columbia University Medical Center research suggests a genomic test may provide detailed information on how well a transplanted heart is performing. The gene expression profiling test is currently used to detect the absence of heart transplant rejection instead of routine invasive heart muscle biopsies, but has now been shown to correlate with oxygen saturation levels, the pressure in the heart before pumping, and the electrical properties of the transplanted heart.

Heart intervention doesn't outweigh medicine in study
In what some leading cardiologists are calling a "blockbuster" study, new research could alter the approach to treating patients who have cardiovascular disease but may not be at immediate risk of heart attack or stroke.

SCAI leaders say courage results unlikely to change use of PCI
Results of the COURAGE trial, presented today at the American College of Cardiology Annual Scientific Session, are unlikely to alter the approach that interventional cardiologists take in treating most patients with chronic stable angina, say leaders from the Society for Cardiovascular Angiography and Interventions, the leading professional society for interventional cardiologists in the United States.

Novel anti-oxidant and anti-inflammatory agent shows effectiveness on key endpoints in trial
Heart attacks are caused by a build-up and instability of plaque in the coronary arteries, which is often a result of chronic inflammation of the blood vessel walls. A study presented today at the American College of Cardiology's 56th Annual Scientific Session assessed whether adding a novel agent with antioxidant and anti-inflammatory properties to optimal medical therapy would reduce coronary events and death among patients with heart disease.

MERLIN TIMI-36 study provides new safety and efficacy data for unique anti-anginal therapy
Chest pain due to a shortage of blood in the heart, known as angina, is a condition that affects millions of Americans. The most recently approved new pharmaceutical approach to treat chronic angina is a novel drug called ranolazine, which was approved in 2006 for use as second line therapy in patients who continue to experience angina despite treatment with another class of anti-anginal medication.

Clevidipine during heart surgery improves blood pressure control
Researchers today reported that an investigational anti-hypertensive therapy may perform better in controlling blood pressure than standard treatments for patients undergoing heart surgery, during a presentation at the American College of Cardiology's 56th Annual Scientific Session. Another study found that measuring a certain peptide can help evaluate dyspnea (shortness of breath) as heart- or lung-related in the general population.

Implant device effectively maintains heart function for transplant-listed patients
Whether a patient is awaiting a heart transplant or living with chronic heart failure, cardiologists are continuously looking for new therapies that address short-term and/or long-term needs of chronically impaired cardiac patients. Research presented today at the American College of Cardiology's 56th Annual Scientific Session reviewed new treatments and interventions, including LVAD implantation and diuretic therapies to support left ventricular function in severely compromised cardiovascular patients.

Disease management programs improve long-term outcomes
More than 30 percent of patients who suffer heart failure die within one year, but education and support programs have been shown to improve that statistic. According to two studies presented today at the American College of Cardiology's 56th Annual Scientific Session, education and support programs designed to care for high-risk cardiac patients with more direct interaction and guidance were successful in both reducing hospital visits and increasing heart failure patients' chances of long-term survival.

Herbal extract extends life for heart failure patients
An herbal medicinal substance, Crataegus Extract WS1442, safely extends the lives of congestive heart failure patients already receiving pharmacological treatment for the disease, according to a study presented today at the American College of Cardiology's 56th Annual Scientific Session. Crataegus Extract WS1442 is an extract of leaves of the Crataegus tree, and is a natural antioxidant. The herb is currently approved for use in some European countries to treat early congestive heart failure.

Jefferson scientists find that plavix appears to be safe during and after heart bypass
Heart surgeons don't have to choose between taking a coronary-bypass patient off the popular anti-clotting drug clopidogrel (Plavix) after off-pump heart bypass surgery or having the patient bleed excessively in the days following surgery, according to a new study by researchers at Jefferson Medical College.

Treatment of in-hospital cardiac patients is focus of Jefferson University presentations
The following summaries are based on presentations by Thomas Jefferson University researchers at the American College of Cardiology's 56th Annual Scientific Sessions in New Orleans.

First step in developing heart hormone-based pill to control high blood pressure
In an era of increasing death and illness from heart and blood vessel disease -- which also can impair kidney function -- Mayo Clinic researchers have designed two promising new cardiovascular treatment approaches.

EVEREST data on use of tolvaptan published in JAMA and featured at ACC
Once-daily dosing with Otsuka's investigational oral medication tolvaptan, a vasopressin receptor antagonist, was associated with improvements in signs and symptoms of acutely decompensated heart failure in hospitalized patients receiving conventional care, without an adverse effect on their long-term survival versus placebo. These data are from the short- and long-term analyses of the international landmark trial EVEREST published in the March 28 issue of JAMA and presented at ACC.

Mayo Clinic study shows drug-eluting stent use in heart patients determined more by insurance type
If you want the best technology available to relieve blocked blood flow to the heart, the choice is a drug-eluting stent. And you are most likely to obtain the drug-eluting stent for reasons that have nothing to do with your medical condition, a new Mayo Clinic study shows.

Children's Hospital Boston presents at the American College of Cardiology Scientific Sessions
Is prenatal cardiac intervention safe? Can children with heart transplants regain enough heart function to safely exercise? Using simulators to practice high-risk resuscitations. These are among the presentations by researchers at Children's Hospital Boston March 26-27.

Heart pumping variations revealed among African- and Chinese-Americans
Generally healthy African-Americans may be at higher risk of heart failure because of racial variations in heart muscle's pumping ability, a Johns Hopkins study suggests.

Study finds coronary procedure adds no benefit over 'optimal medical therapy' alone
Percutaneous coronary intervention plus optimal medical therapy does not improve outcomes in patients with coronary artery disease, compared with optimal medical therapy alone, according to study results presented yesterday at the 56th Annual Scientific Session of the American College of Cardiology in New Orleans, and published online in the New England Journal of Medicine.

Gene test shown to measure heart function after transplant
New Columbia University Medical Center research suggests a genomic test may provide detailed information on how well a transplanted heart is performing. The gene expression profiling test is currently used to detect the absence of heart transplant rejection instead of routine invasive heart muscle biopsies, but has now been shown to correlate with oxygen saturation levels, the pressure in the heart before pumping, and the electrical properties of the transplanted heart.

Heart intervention doesn't outweigh medicine in study
In what some leading cardiologists are calling a "blockbuster" study, new research could alter the approach to treating patients who have cardiovascular disease but may not be at immediate risk of heart attack or stroke.

SCAI leaders say courage results unlikely to change use of PCI
Results of the COURAGE trial, presented today at the American College of Cardiology Annual Scientific Session, are unlikely to alter the approach that interventional cardiologists take in treating most patients with chronic stable angina, say leaders from the Society for Cardiovascular Angiography and Interventions, the leading professional society for interventional cardiologists in the United States.

Novel anti-oxidant and anti-inflammatory agent shows effectiveness on key endpoints in trial
Heart attacks are caused by a build-up and instability of plaque in the coronary arteries, which is often a result of chronic inflammation of the blood vessel walls. A study presented today at the American College of Cardiology's 56th Annual Scientific Session assessed whether adding a novel agent with antioxidant and anti-inflammatory properties to optimal medical therapy would reduce coronary events and death among patients with heart disease.

MERLIN TIMI-36 study provides new safety and efficacy data for unique anti-anginal therapy
Chest pain due to a shortage of blood in the heart, known as angina, is a condition that affects millions of Americans. The most recently approved new pharmaceutical approach to treat chronic angina is a novel drug called ranolazine, which was approved in 2006 for use as second line therapy in patients who continue to experience angina despite treatment with another class of anti-anginal medication.

Clevidipine during heart surgery improves blood pressure control
Researchers today reported that an investigational anti-hypertensive therapy may perform better in controlling blood pressure than standard treatments for patients undergoing heart surgery, during a presentation at the American College of Cardiology's 56th Annual Scientific Session. Another study found that measuring a certain peptide can help evaluate dyspnea (shortness of breath) as heart- or lung-related in the general population.

Implant device effectively maintains heart function for transplant-listed patients
Whether a patient is awaiting a heart transplant or living with chronic heart failure, cardiologists are continuously looking for new therapies that address short-term and/or long-term needs of chronically impaired cardiac patients. Research presented today at the American College of Cardiology's 56th Annual Scientific Session reviewed new treatments and interventions, including LVAD implantation and diuretic therapies to support left ventricular function in severely compromised cardiovascular patients.

Disease management programs improve long-term outcomes
More than 30 percent of patients who suffer heart failure die within one year, but education and support programs have been shown to improve that statistic. According to two studies presented today at the American College of Cardiology's 56th Annual Scientific Session, education and support programs designed to care for high-risk cardiac patients with more direct interaction and guidance were successful in both reducing hospital visits and increasing heart failure patients' chances of long-term survival.

Herbal extract extends life for heart failure patients
An herbal medicinal substance, Crataegus Extract WS1442, safely extends the lives of congestive heart failure patients already receiving pharmacological treatment for the disease, according to a study presented today at the American College of Cardiology's 56th Annual Scientific Session. Crataegus Extract WS1442 is an extract of leaves of the Crataegus tree, and is a natural antioxidant. The herb is currently approved for use in some European countries to treat early congestive heart failure.

Jefferson scientists find that plavix appears to be safe during and after heart bypass
Heart surgeons don't have to choose between taking a coronary-bypass patient off the popular anti-clotting drug clopidogrel (Plavix) after off-pump heart bypass surgery or having the patient bleed excessively in the days following surgery, according to a new study by researchers at Jefferson Medical College.

Treatment of in-hospital cardiac patients is focus of Jefferson University presentations
The following summaries are based on presentations by Thomas Jefferson University researchers at the American College of Cardiology's 56th Annual Scientific Sessions in New Orleans.

First step in developing heart hormone-based pill to control high blood pressure
In an era of increasing death and illness from heart and blood vessel disease -- which also can impair kidney function -- Mayo Clinic researchers have designed two promising new cardiovascular treatment approaches.

EVEREST data on use of tolvaptan published in JAMA and featured at ACC
Once-daily dosing with Otsuka's investigational oral medication tolvaptan, a vasopressin receptor antagonist, was associated with improvements in signs and symptoms of acutely decompensated heart failure in hospitalized patients receiving conventional care, without an adverse effect on their long-term survival versus placebo. These data are from the short- and long-term analyses of the international landmark trial EVEREST published in the March 28 issue of JAMA and presented at ACC.

Mayo Clinic study shows drug-eluting stent use in heart patients determined more by insurance type
If you want the best technology available to relieve blocked blood flow to the heart, the choice is a drug-eluting stent. And you are most likely to obtain the drug-eluting stent for reasons that have nothing to do with your medical condition, a new Mayo Clinic study shows.

Children's Hospital Boston presents at the American College of Cardiology Scientific Sessions
Is prenatal cardiac intervention safe? Can children with heart transplants regain enough heart function to safely exercise? Using simulators to practice high-risk resuscitations. These are among the presentations by researchers at Children's Hospital Boston March 26-27.

Heart pumping variations revealed among African- and Chinese-Americans
Generally healthy African-Americans may be at higher risk of heart failure because of racial variations in heart muscle's pumping ability, a Johns Hopkins study suggests.

New blood thinner may work without bleeding risk
Clinical trial of new blood thinner shows promise of significantly reducing the risk of heart attack and death with no statistical increase in major and minor bleeding events.

Pairing medical therapy with coronary intervention fails to reduce heart disease deaths
Results of research presented today at the American College of Cardiology's 56th Annual Scientific Session showed that percutaneous coronary interventions combined with optimal medical therapy (OMT) was no more effective than OMT alone in preventing heart attacks and other cardiac events among patients with coronary artery disease. The study will be simultaneously published in the New England Journal of Medicine and will appear in the April 12 print issue.

Drug/intervention combinations offer benefit in severe CVD
While millions of Americans suffer from severe cardiac dysfunction, only about 3,000 heart transplants are possible each year. In the meantime, doctors are trying to identify new combinations of medicines and interventions that will increase survival rates among this high-risk population. Research presented today at the American College of Cardiology's 56th Annual Scientific Session offers new insight into the most effective therapies for patients with severe left ventricular dysfunction, cardiogenic shock and perioperative hypertension.

Studies highlight 'real world' use, safety of drug-eluting stents
Research presented today at the American College of Cardiology's Innovation in Intervention: i2 Summit 2007, paints a picture of the "real world" use of drug-eluting stents and offers new insight into the connection between blood clotting, or thrombosis, in the stent -- a dangerous complication -- and adherence and responsiveness to anticlotting medication.

Drug and procedural interventions offer better quality of life
Emergency and nonemergency care of cardiovascular disease have continually improved over the past decade, thanks to improved quality of care, novel procedures and better therapies. Research on improved care of cardiovascular disease shows improvements with a combination of drug and risk factor interventions. Three studies presented today at the American College of Cardiology's 56th Annual Scientific Session assess how continued improvements in cardiac care can lead to enhanced clinical practice and improved quality of life.

Studies highlight advances in diagnosis, medical therapy
Three studies being presented today at the American College of Cardiology's Innovation in Intervention: i2 Summit 2007 highlight the breadth of research propelling advances in clinical cardiology. One study explores the best medical and interventional treatment for patients with acute coronary syndromes, the second demonstrates the long-lasting promise of nonsurgical approaches to the repair of heart valves, and the third highlights a new drug-exercise combination that improves image quality and reduces side effects.

Sodium hydration therapies equally effective
In patients undergoing cardiac catheterization, contrast dye injection can sometimes cause contrast-induced nephropathy (CIN), otherwise known as acute renal failure. According to a study presented today at the American College of Cardiology's Innovation in Intervention: i2Summit, peri-procedural hydration treatment with either sodium bicarbonate or sodium chloride show similar rates of protection against CIN.

Study identifies steps to improve safety of renal artery stenting
High blood pressure is the most common chronic medical condition in the US, and the most common identifiable cause is renal artery stenosis. Renal artery stenting is a widely performed but controversial procedure for patients. Use of a platelet inhibitor may make renal artery stenting safer for patients, especially when used in combination with an embolic protection device, according to a study presented today at the American College of Cardiology's Innovation in Intervention: i2 Summit.

Cerebral embolic protection and carotid stent systems
High-risk surgical patients in community hospital settings can safely benefit from the use of new embolus-removing and stent-inserting systems, according to a study presented today at the American College of Cardiology's Innovation in Intervention: i2 Summit. The use of these systems to treat carotid artery blockage has only been studied in limited clinical trials, prior to FDA approval, in the pivotal SECuRITY study (2004).

Value of stent-coating drugs questioned
New research about possible additive drugs to help reduce the reclosing of an artery after a metal stent has been inserted to keep it open was presented today at the American College of Cardiology's Innovation in Intervention: i2 Summit.

Drug that mimics 'good' cholesterol has mixed effect on coronary atherosclerosis
The results of a study presented today at the American College of Cardiology’s 56th Annual Scientific Session showed that CSL-111, a drug that mimics HDL, did not significantly reduce plaque in coronary arteries in patients with a recent episode of ACS. However, patients taking the drug showed improvement in two indexes that assess changes in the blood vessels.

Dual renin system blocking drug combo provides additional blood pressure-lowering effects
A combination of two medicines that act against the effects of the enzyme renin are more effective in lowering blood pressure than either of the medicines alone, according to a study presented today at the American College of Cardiology’s 56th Annual Scientific Session.

Despite significantly raising HDL, torcetrapib failed to slow the progression of coronary plaques
Investigators reported today at the American College of Cardiology's 56th Annual Scientific Session that torcetrapib, a drug that substantially raises high-density lipoprotein cholesterol or HDL (the "good" cholesterol), did not slow the progression of plaque buildup in the coronary arteries as measured using an ultrasound probe (IVUS).

Combination HDL/LDL therapy has no effect on plaque build-up
Two RADIANCE studies presented today at the American College of Cardiology's 56th Annual Scientific Session assessed the effects of adding torcetrapib to atorvastatin among patients to improve their cholesterol levels. Although the ILLUMINATE study and other trials involving torcetrapib were recently stopped because of safety concerns, the effect of the drug on carotid intima-media thickness (CIMT) may provide useful information on whether it slows the progression of atherosclerosis.

Jefferson scientists find that drug-eluting stents are disappointing in bypass grafts -- sometimes
While drug-eluting stents are effective in keeping open bypassed heart veins that aren't too diffuse (filled with cholesterol plaque), a new study by cardiologists at Jefferson Medical College shows that they fare less well in keeping open bypassed veins with longer blockages. The researchers suggest that doctors think twice before inserting the drug-coated stents in such extensively diseased bypassed grafts.

Place more than race tied to heart disease risk
Where you live might play a bigger role in your risk for heart disease than your ethnicity or race. New research reveals that rural residents were more knowledgeable about healthy eating and heart disease risk than urban residents, but that urban residents were more motivated and optimistic about getting healthy. The findings could help health-care professionals better target heart disease prevention programs.

Drug does not reduce risk of death for heart attack patients with refractory shock
The medication tilarginine, a drug that was believed could be beneficial for patients who develop cardiogenic shock (low blood pressure due to impaired cardiac function) after a heart attack, did not reduce the risk of death up to six months after a heart attack, according to a JAMA study published online March 26. The study is being released early to coincide with its presentation at the American College of Cardiology's annual conference.

Infusion with reconstituted HDL may have some benefit for atherosclerosis
Preliminary research suggests that use of reconstituted HDL may have some benefit in coronary atherosclerosis, according to a JAMA study published online March 26. The study is being released early to coincide with its presentation at the American College of Cardiology's annual conference.

Heart pumping variations revealed among African and Chinese Americans
Generally healthy African Americans may be at higher risk of heart failure because of racial variations in heart muscle's pumping ability, a Johns Hopkins study suggests.

Mayo Clinic says new process to treat heart patients quickly saves lives, heart damage
Mayo Clinic has designed a new system to speed critical care to acute heart attack patients that dramatically reduces the time that elapses before patients undergo a life-saving procedure -- by as much as 45 percent in some cases.

IPod doctors
Researchers Mike Barrett and Archana Saxena listen to heart sounds on an iPod. They found that repetitive listening improved physicians stethoscope skills significantly. (Photo by Joseph V. Labolito / Temple University)
iPods help docs improve stethoscope skills

The ability of physicians to recognize abnormal heart sounds is only fair at best. Fortunately, the solution is simple: Listening repeatedly. In fact, intensive repetition -- listening at least 400 times to each heart sound on an iPod -- significantly improved the stethoscope abilities of doctors, according to a study presented at the American College of Cardiology's annual meeting.

Novel therapy for lipid disorders shows mixed results in early clinical trials
Preliminary research suggests that use of a novel, potent drug to treat cholesterol disorders decreases triglycerides and increases HDL-C, the "good" cholesterol, but also raises some safety concerns, according to a study in the March 28 issue of JAMA.

Statin therapy slows progression of arterial thickening; halts but does not reverse atherosclerosis
Among low-risk middle-aged people with subclinical atherosclerosis, the cholesterol-lowering drug rosuvastatin reduces the rate of progression of arterial thickening and stops but does not reverse atherosclerotic disease, according to a study in the March 28 issue of JAMA.

Heart failure medication provides some symptom relief
A medication used to treat heart failure, tolvaptan, appears to improve some symptoms and signs of heart failure during hospitalization, but does not reduce the risk of re-hospitalization or death, according to two articles in the March 28 issue of JAMA.

Crestor effective at halting early atherosclerosis
An international study using ultrasound technology has found that the most potent cholesterol-lowering drug is also effective at halting early changes in the blood vessels that can lead to atherosclerosis.

Second generation drug-eluting stent system challenges current gold standard
While research shows that drug-eluting stents effectively reduce restenosis and revascularization compared to bare-metal stents, questions surrounding the safety of drug-eluting stents continue to dominate headlines. A study presented today at the American College of Cardiology’s Innovation in Intervention: i2 Summit surveys the safety and efficacy of the second generation Xience Everolimus Eluting Coronary Stent System (EES), compared to the current gold standard paclitaxel-eluting stent (PES), to determine if it offers similar or enhanced outcomes.

Studies examine issues in pediatric cardiology
Heart problems in children are quite different from those in adults, and four studies presented today at the American College of Cardiology’s 56th Annual Scientific Session look at how pediatric cardiologists take different approaches to better understand and manage cardiovascular disease in this population, including insights into fundamental cardiac mechanisms and testing of new procedures. ACC.07 is the premier cardiovascular medical meeting, bringing together cardiologists and cardiovascular specialists to further breakthroughs in cardiovascular medicine.

Studies explore lifestyle choices and heart risks
Genetics and family history play a large role in a person’s risk for heart disease, but factors in diet, lifestyle and the environment are also thought to influence susceptibility to the disease. A number of studies presented today at the American College of Cardiology’s 56th Annual Scientific Session look at how health-related behaviors can influence a person’s risk for cardiovascular disease.

Low-dose aspirin beats high-dose after cardiac surgery
The use of medicines to fight cardiovascular disease has been a primary focus of research in this area for the past several decades, as combinations of interventions and medicinal therapy have gradually begun to increase long-term survival rates. Two studies presented today at the American College of Cardiology’s 56th Annual Scientific Session look at the measurable impact of the use of aspirin and other maintenance therapies.



© Copyright 2007 by Doctors Lounge