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American Heart Association, Nov. 14-18, 2009

Last Updated: November 20, 2009.

 

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The American Heart Association Scientific Sessions took place Nov. 14 to 18 in Orlando, Fla., and attracted more than 20,000 attendees from around the world. The meeting presented groundbreaking research in basic and clinical science, and featured a new organizational scheme aimed at fostering interaction between different disciplines of cardiology.

"We developed seven cardiovascular cores which were strategically located throughout the convention center," said program chair, Mariell L. Jessup, M.D., of the University of Pennsylvania School of Medicine in Philadelphia. "Within each core were basic scientists, clinicians, and translational and population scientists. In past years, we've had basic scientists at one end of the convention center and clinicians at the other. So this was our attempt to reproduce how people interact with each other in the real world."

The seven cores included: Cardiovascular Imaging; Epidemiology and Prevention of Cardiovascular Disease: Physiology, Pharmacology, and Lifestyle; Genetics, Genomics and Congenital Cardiovascular Disorders; Heart Rhythm Disorders and Resuscitation Science; Myocardium: Development, Function, and Failure: Vascular Disease: Catheter-Based and Surgical Interventions; and Vascular Disease: Biology and Clinical Science (Non-Interventional).

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Meeting highlights included the presentation of 32 late-breaking studies. "There's exciting research going on in almost every area," Jessup said. "We saw many pieces of science that added to our previous knowledge, many of which will help shape guidelines."

In one late-breaking study -- the Clopidogrel After Surgery for Coronary Artery DiseasE (CASCADE) Randomized Controlled Trial -- researchers randomly assigned 113 coronary artery bypass grafting patients to receive either aspirin alone or aspirin plus clopidogrel. After a year, the researchers found that aspirin alone was just as effective at keeping grafts open as the combination therapy.

"I think this study presents both good news and bad news," senior author, Alexander Kulik, M.D., of the Boca Raton Community Hospital in Florida, said in a statement. "The good news is that patients and their doctors can expect more than 90 percent of vein grafts to remain open one year after surgery with the use of aspirin and statins. In this study there was no statistical difference in the vein graft patency rate between the 93.2 percent for the aspirin-only group versus 94.3 percent for those who received aspirin plus clopidogrel. However, it is bad news for the advancement of the cardiac surgery field. It has been more than 10 years since the last advance in medical therapy for bypass grafts, which was a study showing that statin therapy helps keep vein grafts open."

The study was partly supported by Bristol-Myers Squibb Sanofi Canada; two authors reported financial relationships with the company.

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"Another interesting trial looked at six different platelet tests which have been used to predict which patients will have resistance to clopidogrel at the time of percutaneous coronary intervention (PCI)," Jessup said. "The researchers found that three of the tests were effective in predicting who was going to have problems or not, and three of the tests were ineffective."

The POPULAR (Do platelet function assays predict clinical outcomes in clopidogrel pre-treated patients undergoing elective PCI) trial compared six different tests of platelet reactivity in 1,069 patients who underwent stent replacement. After a year, the researchers found that the incidence of the primary end point -- a composite of all-cause death, heart attack, urgent revascularization, stroke, or stent thrombosis -- was significantly higher in patients who had high platelet reactivity on the three following tests: Light Transmittance Aggregometry (LTA), VerifyNow-P2Y12®-cartridge, and the Plateletworks™ assay. They had a doubled risk compared to those who had low reactivity (12.1 versus 6 percent).

"Only a minority of centers routinely uses platelet reactivity testing to guide therapy, but it is used extensively as a research tool," lead author, Jurrien M. ten Berg, M.D., of St. Antonius Hospital in Nieuwegein, Netherlands, said in a statement. "I think we are on the brink of making platelet reactivity a clinical tool."

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In another late-breaking trial -- a new analysis of the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) -- researchers reported that treatment with the anemia drug darbepoetin alfa has more risks than benefits in diabetic patients with kidney disease, anemia, or a history of cardiovascular disease or stroke. The risk of the primary end point -- a composite of death or cardiovascular events -- was significantly higher in treated patients than in those who received placebo.

"This trial is an excellent example of why surrogate markers, such as increased hemoglobin levels, should not take the place of clinical outcomes data," lead author, Marc A. Pfeffer, M.D., of Harvard University and Brigham and Women's Hospital in Boston, said in a statement. "TREAT underscores the importance of placebo-controlled trials to assess risks as well as benefits. This new data will help physicians and patients make more informed decisions about the use of erythropoiesis-stimulating agents, and we believe for many that the risks will outweigh the benefits."

The study was supported by Amgen; Pfeffer reported financial relationships Amgen and other pharmaceutical companies.

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AHA: Studies Find Ticagrelor Superior to Clopidogrel

THURSDAY, Nov. 19 (HealthDay News) -- Ticagrelor may have more effective antiplatelet activity than clopidogrel, according to research presented this week at the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Early Repolarization Linked to Cardiac Death Risk

THURSDAY, Nov. 19 (HealthDay News) -- In middle-aged patients, early repolarization in the inferior leads of a standard electrocardiogram is associated with an increased long-term risk of cardiovascular death, according to a study published online Nov. 16 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Dietary Interventions May Reduce Heart Risks

THURSDAY, Nov. 19 (HealthDay News) -- A low-fat diet may reduce the risk of cardiovascular disease in many patients, but a moderate-fat diet may be optimal for patients with metabolic syndrome, according to research presented this week at the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Report Cards Lead to Few Hospital Performance Changes

WEDNESDAY, Nov. 18 (HealthDay News) -- A publicly released report card on hospitals' performance on cardiac quality indicators didn't significantly improve their performance on process-of-care indicators related to acute myocardial infarction (AMI) or congestive heart failure (CHF), according to Canadian research published online Nov. 18 in the Journal of the American Medical Association. The study was published online ahead of publication in the December 2 issue due to its presentation at the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: High-Dose Losartan May Be Superior in Heart Failure

WEDNESDAY, Nov. 18 (HealthDay News) -- In patients with heart failure, treatment with high-dose losartan is associated with superior clinical outcomes compared to treatment with low-dose losartan, according to a study published online Nov. 17 in The Lancet to coincide with the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Two Separate Studies Find Cangrelor Not Superior

TUESDAY, Nov. 17 (HealthDay News) -- In patients undergoing percutaneous coronary intervention (PCI), the use of cangrelor is not superior to the use of clopidogrel or placebo, according to two studies published online Nov. 15 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Proton Pump Inhibitors May Up Post-PCI Mortality

TUESDAY, Nov. 17 (HealthDay News) -- In patients who undergo percutaneous coronary intervention with drug-eluting stents, use of proton pump inhibitors is associated with an increased risk of all-cause mortality, according to research presented this week at the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Phone Care Helps Fight Post-Heart Surgery Depression

TUESDAY, Nov. 17 (HealthDay News) -- A telephone-based care program, conducted by nurses in collaboration with patients' primary care physicians and supervised by a psychiatrist, helps combat post-surgical depression among coronary artery bypass graft (CABG) patients, according to a study published online Nov. 16 in the Journal of the American Medical Association to coincide with the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Meditation Found Helpful in Coronary Heart Disease

MONDAY, Nov. 16 (HealthDay News) -- In patients with coronary heart disease, stress-reducing transcendental meditation may significantly reduce the rate of heart attack, stroke and death, according to research presented this week at the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Right Ventricular Pacing Has Deleterious Effects

MONDAY, Nov. 16 (HealthDay News) -- In patients with bradycardia and normal ejection fraction, conventional right ventricular pacing is associated with reduced left ventricular ejection fraction and adverse left ventricular remodeling compared to biventricular pacing, according to a study published online Nov. 15 in The New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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AHA: Niacin Can Affect Carotid Intima-Media Thickness

MONDAY, Nov. 16 (HealthDay News) -- In patients at high risk of cardiovascular disease, adjunctive therapy with niacin is superior to therapy with ezetimibe, according to a study published online Nov. 15 in The New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

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