American College of Cardiology Meeting March 16 – 18 , 2019 (New Orleans, LA)
CardioMEMS PAS trial1: The use of a CardioMEMS sensor (monitoring pulmonary artery pressure) in 1200 heart failure (HF) patients resulted in a 58% reduction in HF-related hospitalization rate in the year following the sensor placement as compared to the previous year.
COACT trial2: Immediate angiography (within 2 hours from randomization) was shown to be not better than delayed angiography (after neurologic recovery) with respect to survival at 90 days in 552 cardiac arrest patients (no STEMI).
WRAP-IT trial3: In 6983 patients undergoing cardiac implantable electronic device procedures the use of an absorbable antibiotic-eluting envelope resulted in significantly lower incidence of device infection as compared to standard care.
CLEAR Wisdom trial4: The addition of bempedoic acid to maximum-tolerated statin therapy was shown to be safe and effective in reducing LDL-cholesterol vs placebo in 779 patients at high cardiovascular risk with hypercholesterolemia.
POET trial5: In 400 patients with infective endocarditis on the left side of the heart, administration of oral antibiotics was not inferior to intravenous administration in preventing adverse events at 6 months follow-up.
ALCOHOL-AF trial6: Abstinence from alcohol in 140 atrial fibrillation (AF) patients reduced AF recurrence and burden as compared to usual (moderate) alcohol consumption, together with a BMI reduction at 6 months follow-up.
Dietary cholesterol and eggs consumption vs CVD7: Higher risk of CVD incidence and all-cause mortality was associated in a dose-response manner with higher intake of dietary cholesterol or eggs in 29615 US adults pooled from 6 prospective cohort studies.
AUGUSTUS trial8: In 4614 atrial fibrillation patients with recent history of acute coronary syndrome or PCI and treated with P2Y12 inhibitor, an antithrombotic therapy with apixaban, but without aspirin, caused less bleeding and fewer hospitalizations, with no significant differences in terms of ischemic events, as compared with therapies including a vitamin K antagonist. Aspirin caused higher incidence of bleeding as compared to placebo, with no difference in terms of hospitalization, death and ischemic events rate.
SMART-CHOICE trial9: In 2993 unselected patients undergoing PCI with drug-eluting stent, 3 months dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy was shown to be non-inferior to 12 months DAPT.
STOPDAPT 2 trial10: One month DAPT therapy (followed by clopidogrel monotherapy) was shown to reduce bleeding without an increase in ischemic events as compared to 12 months DAPT therapy (followed by aspirin monotherapy) in 3045 stable CAD and ACS patients undergoing PCI. One month therapy was superior to the 12 month therapy at preventing net adverse ischemic events (NACE, bleeding and ischemia, primary endpoint). In particular it was noninferior at preventing major adverse ischemic events and superior at preventing TIMI major/minor bleeding. Therefore, authors conclude that 1 month DAPT therapy (followed by clopidogrel monotherapy) provides a net clinical benefit as it reduces bleeding without an increase in ischemia.
COAPT quality of life substudy11: Patients in the transcatheter mitral valve repair arm were characterized by a generalized better health status and larger improvements at 24 months with respect to baseline condition, according to the Kansas City Cardiomyopathy Questionnaire (KCCQ), as compared to the maximally tolerated guideline-directed medical therapy arm.
PARTNER 3 trial12: Transcatheter aortic valve replacement with a balloon-expandable valve in 1000 patients with severe aortic stenosis at low surgical risk caused significantly lower rate of a composite of death, stroke and re-hospitalization at 1 year as compared with surgical valve replacement.
Evolut Low Risk trial13: Transcatheter aortic valve replacement with a self-expandable supraannular aortic valve bioprosthesis was shown to be non-inferior to surgical replacement, in 1403 severe aortic stenosis patients at low surgical risk, with respect to 24 months composite of death and disabling stroke.
SAFARI-STEMI trial14 (terminated early due to futility): in 2292 STEMI patients undergoing primary PCI, radial access was not superior to femoral access at 30 days follow-up in terms of all-causes death mortality or incidence of ischemic events.
DEFINE-PCI trial15: High incidence of residual disease after PCI (assessed by iFR) despite excellent angiographic outcome was shown in 467 patients with stable and unstable angina.
- Presented by Shavelle DM at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 17, 2019.
- N Engl J Med 2019;DOI:10.1056/NEJMoa1816897.
- N Engl J Med 2019;DOI:10.1056/NEJMoa1901111.
- Presented by Goldberg AC at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 18, 2019.
- N Engl J Med 2019;380:415-424DOI:10.1056/NEJMoa1808312.
- Presented by Voskoboinik A at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 18, 2019.
- JAMA 2019;321:1081-109510.1001/jama.2019.1572.
- N Engl J Med 2019;DOI:10.1056/NEJMoa1817083.
- Presented by Hahn J-Y at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 18, 2019.
- Presented by Watanabe H at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 18, 2019.
- J Am Coll Cardiol 2019;DOI:10.1016/j.jacc.2019.02.010.
- N Engl J Med 2019;DOI:10.1056/NEJMoa1814052.
- N Engl J Med 2019;DOI:10.1056/NEJMoa1816885.
- Presented by Le May MR at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 18, 2019.
- Presented by Jeremias A at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 17, 2019.
Author: Lorena Casadonte