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Medscape Conference Coverage, based on selected sessions at the:
American College of Cardiology 2005 Annual Scientific Session
March 6 - 9, 2005, Orlando, Florida

This activity is not sanctioned by, nor a part of, the American College of Cardiology.


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Topic Overviews
Highlights of the American College of Cardiology Annual Scientific Session 2005 CME/CE
Physicians - up to 1.25 hour(s) of AMA PRA category 1 credit;
Registered Nurses - up to 1.5 Nursing Continuing Education contact hour(s)
•ASCOT-BPLA: Calcium Blocker/ACE Inhibitor Regimen Superior to Beta-Blocker/Diuretic Regimen
James H. O'Keefe, Jr., MD, FACC; Hussam Abuissa, MD
•ACE Inhibitors or ARBs for Prevention of Type 2 Diabetes: A Meta-Analysis of Randomized Clinical Trials
James H. O'Keefe, Jr., MD, FACC; Hussam Abuissa, MD
•Update on Cardiac Device Therapy From the American College of Cardiology Annual Scientific Session
Anne B. Curtis, MD, FACC, FAHA
More...
Expert Interview
The "Hate-Love" Relationship With Blood Pressure: An Expert Interview With Marc Pfeffer, MD, PhD
Under what circumstances do we not want to use the most effective blood-pressure-lowering drugs, unless it's because they have other cardioprotective properties?
Session Coverage
ACS at the 2005 ACC
Christopher Cannon, MD, highlights the major clinical trials presented at the ACC that will have the most impact on changing the way we practice medicine.
Endothelial Function and Lipid Changes
Does statin therapy improve endothelial function -- or doesn't it?
Content
TNT: Treating to New Targets
The evidence continues to accumulate that when it comes to LDL cholesterol, "lower is better" -- but how do we achieve that?
ASCOT-BPLA: Blood Pressure-Lowering Arm of the Anglo-Scandinavian Cardiac Outcomes Trial
More -- although perhaps not the last -- proof that the "newer" antihypertensive treatment strategy of CCB plus ACE inhibitor is better than beta-blocker plus diuretic for cardioprotection.
Parecoxib and Valdecoxib for Postoperative Pain Following CABG or Major General Surgery
The risk for adverse events was seen only with the IV coxib prodrug in CAGB patients -- so careful attention should be paid to exactly which patients, on which drug, are at risk.
WHS: Women's Heath Study -- Aspirin and Vitamin E for the Primary Prevention of Cardiovascular Disease
It appears that aspirin protects women against stroke but not cardiovascular events; for men it's the reverse; and vitamin E is not protective at all.
RIO-Europe: Rimonabant in Obesity Europe Study
One more piece of the puzzle in the overall picture of a monotherapy for metabolic risk factors.
VERITAS: Value of Endothelin Receptor Inhibition With Tezosentan in Acute Heart Failure Studies
Is this the end of commercial development of endothelin antagonists for the treatment of chronic heart failure? Should it be?
Cardiac Rhythm Management
OPTIC: Optimal Pharmacological Therapy in Implantable Cardioverter Defibrillator Patients
It appears that the number of ICD shocks -- with their attendant impact on the patient -- can be successfully reduced with appropriate drug therapy.
CARE-HF: Cardiac Resynchronization in Heart Failure Study
We know that CRT improves functional status, but what about all-cause death and hospitalizations?
COMPASS-HF: Chronicle Offers Management to Patients With Advanced Signs and Symptoms of Heart Failure Study
Optimal medical care guided by an implantable device that continuously monitors intracardiac pressure shows promise in reducing morbidity in HF patients.
CACAF: Catheter Ablation for the Cure of Atrial Fibrillation Study
The first randomized, controlled trial to assess ablation and antiarrhythmic drug therapy vs drug therapy alone in AF patients suggests that the long-term efficacy of ablation is independent of the use of antiarrhythmics.
Drug-Eluting Stents
ISAR-DIABETES: Paclitaxel-Eluting Stent Versus Sirolimus-Eluting Stent for the Prevention of Restenosis in Diabetic Patients With Coronary Artery Disease
Is one stent superior to another in this high-risk patient population?
REALITY: Prospective, Randomized, Multicenter Head-to-Head Comparison of Cypher and Taxus Stent Systems
Another head-to-head comparison suggests that one stent may be associated with a higher rate of stent thrombosis.
SIRTAX: Randomized Comparison of a Sirolimus- vs a Paclitaxel-Eluting Stent for Coronary Revascularization
The results of the SIRTAX study complement those of other head-to-head comparisons; read why.
ENDEAVOR II: A Randomized Comparison of the Endeavor ABT-578 Drug-Eluting Stent With a Bare Metal Stent for Coronary Revascularization
Another drug-eluting stent makes its mark in patients with single de novo coronary artery lesions.
ARTS II: Arterial Revascularization Therapies Study Part II - Sirolimus-Eluting Stents vs PCI and CABG at 1 Year
Is the use of a sirolimus-eluting stent noninferior to that of CABG in complex patients with multivessel disease?
TAXUS-V De Novo: Clinical and Angiographic Results of the Taxus Stent in Complex Lesions
Previous studies have demonstrated the safety and efficacy of the Taxus paclitaxel-eluting stent. How will it fare in a more complex patient population?
Reperfusion/Revascularization Strategies
BRAVE-2: Beyond 12 Hours Reperfusion Alternative Evaluation Trial
Is it time to amend current practice guidelines to recommend an invasive strategy in AMI patients presenting > 12 hours after symptom onset?
CLARITY-TIMI 28: Clopidogrel as Adjunctive Reperfusion Therapy -- Thrombolysis in Myocardial Infarction 28
More evidence in favor of adding clopidogrel to standard fibrinolytic therapy in STEMI patients.
COMMIT/CCS-2: Clopidogrel and Metoprolol in Myocardial Infarction Trial/Second Chinese Cardiac Study -- The Clopidogrel Arm
Adding clopidogrel a day keeps the doctor...
COMMIT/CCS-2: Clopidogrel and Metoprolol in Myocardial Infarction Trial/Second Chinese Cardiac Study -- The Metoprolol Arm
Early administration of metoprolol in the AMI setting is associated with more harm than good.
ARMYDA-2: Antiplatelet Therapy for Reduction of Myocardial Damage During Angioplasty Study
Does pretreatment with a loading dose of 600 mg of clopidogrel, instead of the conventional dose of 300 mg, reduce the risk of periprocedural MI?
AGENT 3: Angiogenic Gene Therapy 3 Trial -- Intracoronary Administration of Ad.FGF-4 in Patients With Stable Angina -- 1-Year Results
Do the results of AGENT-3 bring us one step closer to or move us one step back from using angiogenic factors for patients with stable angina?
GIPS II: Glucose Insulin Potassium Study in STEMI Patients
Does GIP infusion improve survival in STEMI patients without signs of heart failure?
PROMISE: Protection Devices in PCI-Treatment of Myocardial Infarction for Salvage of Endangered Myocardium Study
Does the use of distal protection during PCI improve myocardial perfusion and infarct size compared with PCI alone in AMI patients?
PREMIER: Prevention of MI Early Remodeling -- The Effects of PG-116800
The use of the MMP inhibitor, PG-116800, did not influence change in left ventricular end diastolic volume index from baseline to 90 days in AMI patients.
Conference News
COMPASS-HF Trial Finds Continuous Monitoring of Intracardiac Pressure Associated with Significant Reduction in Heart Failure Hospitalization 3/17/05
[Medscape CRM News]
Reduced hospitalizations were seen in patients already receiving optimal medical care by expert specialists; this finding validates the integration of new technology with best medical care.
Catheter Ablation Proves Superior to Antiarrhythmic Drugs Alone for the Treatment of Paroxysmal or Persistent Atrial Fibrillation: Results of the CACAF Study 3/15/05
[Medscape CRM News]
The long-term efficacy of catheter ablation for AF was independent of drug therapy; complex study population and long-term ECG telephonic monitoring strengthened results.
Early IV Beta Blockade May Be Harmful in Acute MI 3/15/05
[Medscape Medical News]
The risk for cardiogenic shock may outweigh the benefit of reduced reinfarction, according to results from COMMIT/CCS-2.
Pioglitazone May Reduce Neointimal Growth in Coronary Stents in Nondiabetic Patients 3/15/05
[Medscape Medical News]
An oral diabetic agent reduced stent restenosis in nondiabetic patients without affecting their metabolic profile.
Trio of Stem Cell Studies Show Promise in Restoring Damaged Myocardium 3/15/05
[Medscape Medical News]
The results of the studies establish a strong precedent for conducting future long-term trials.
Enhanced External Counterpulsation Improves Cardiac Output in Heart Failure Patients 3/15/05
[Medscape Medical News]
In the PEECH study, enhanced external counterpulsation mechanically improved exercise time for at least 6 months in patients with stable heart failure receiving optimal medical therapy.
Calcium Channel Blocker and ACE Inhibitor Combo Shows Benefit for Hypertension 3/14/05
[Medscape Medical News]
In the ASCOT BPLA study, standard therapy with beta-blockers and diuretics was less effective.
Aspirin Resistance Found in More Than One Quarter of Cardiac Patients on Aspirin Therapy 3/14/05
[Medscape Medical News]
Cardiac patients at highest risk for death have highest risk for aspirin sensitivity.
Ezetimibe/Simvastatin May Be More Effective at Lowering Cholesterol Than Atorvastatin 3/14/05
[Medscape Medical News]
The combination may prove useful in treating to new lower cholesterol targets, according to an equivalency trial, but further study is warranted.
Low-Dose Aspirin May Be Safest for Cardiovascular Event Prophylaxis 3/11/05
[Medscape Medical News]
A meta-analysis confirmed that bleeding risk increases with doses higher than 100 mg.
Weight Loss Maintained With Rimonabant After Two Years 3/9/05
[Medscape Medical News]
The data confirm earlier positive results, and the investigational drug is likely to be fast-tracked for FDA approval.
Aggressive Lipid-Lowering Therapy Reduces Cardiovascular Events 3/8/05
[Medscape Medical News]
Use of statins to reduce low-density lipoprotein cholesterol to less than 80 mg/dL provided gains without significant toxicity.
Valdecoxib, Parecoxib Use Not Associated With Increased Stroke or MI Risk After General Surgery 3/8/05
[Medscape Medical News]
But in a second study, use of the COX-2 inhibitors in coronary artery bypass graft patients found a significant increase in cardiovascular events.
Noninvasive Cholesterol Skin Test Can Identify Asymptomatic Atherosclerosis 3/7/05
[Medscape Medical News]
The test does not require fasting, and it may encourage prevention discussions in the physician's office.
Cypher Stent Edges Out Taxus in Three Studies 3/7/05
[Medscape Medical News]
In one study, the eight-month thrombosis rate in a subgroup of patients was significantly higher in the Taxus group compared with the Cypher group.

 
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