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Medscape Conference Coverage, based on selected sessions at the:
European Society of Cardiology 2005 Congress
September 3 - 7, 2005, Stockholm, Sweden

Authors: Linda Brookes, MSc; Luis Gruberg, MD

This activity is not sanctioned by, nor a part of, the European Society of Cardiology.


Also On This Page:Hot Lines and Clinical Trial UpdatesConference NewsInternational Perspective
Expert Interview
Blood Pressure-Lowering Results of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) -- Implications for Clinical Practice: An Expert Interview With Franz H. Messerli, MD, FACC
Should ASCOT be considered the last straw as far as the use of beta-blockers in uncomplicated hypertension is concerned?
Faculty Reviews
Important New Results Should Lead to Big Changes in the Management of ACS
Christopher Cannon, MD, discusses the results of several large, randomized clinical trials presented at the ESC that will surely have a large impact, both positive and negative, on the current management of acute coronary syndromes.
Stent Thrombosis and Drug-Eluting Stents: Risk and Prevention
Can we speculate that patients who have a high risk score for stent thrombosis should undergo platelet function testing? Should these patients be treated with prolonged dual antiplatelet therapy? Should we avoid deploying drug-eluting stents in these patients?
Hot Lines and Clinical Trial Updates
ASCOT: Anglo Scandinavian Cardiac Outcomes Trial
In contradistinction to the ALLHAT results, the ASCOT results have demonstrated a clear superiority for a CCB/ACE inhibitor-based antihypertensive regimen, but will this result in a change in the guidelines?
CARE-HF: Long-term Effects of Cardiac Resynchronization on Mortality and Echocardiography and Cost-effectiveness Analyses
CARE-HF was one of the first trials that documented a mortality benefit from CRT. Now the results from 3 substudies demonstrate that mortality is reduced in the long term and is associated with continued reverse remodeling -- all of which translate into a cost-effective therapy.
CLARITY-TIMI 28: Clopidogrel as Adjunctive Reperfusion Therapy - Thrombolysis in Myocardial Infarction 28: PCI and Ambulance Substudies
Is administering clopidogrel before PCI associated with better outcomes than patients receiving clopidogrel at the time of intervention? What influence does ambulance transportation have on outcomes?
STEEPLE: Safety and Efficacy of Enoxaparin in Percutaneous Coronary Intervention Patients
Low-molecular-weight heparin vs unfractionated heparin in patients undergoing nonemergent PCI -- is it time to change the guidelines?
RITA 3: Randomized Intervention Trial of Unstable Angina -- Long-term Impact of an Interventional Strategy in Non-ST-Elevation ACS
RITA 3 -- the largest trial with the longest follow-up assessing an interventional approach in ACS patients -- supports the use an aggressive intervention, particularly among high-risk patients.
OASIS 5: Efficacy and Safety of Fondaparinux vs Enoxaparin in ACS Patients
Clinical event rates were similar, but bleeding rates significantly favored...
NORVIT: The Norwegian Vitamin Trial
No causal relationship between homocysteine levels and vascular disease has been established, and use of B vitamins cannot currently be recommended in post-MI patients, but is that the final word?
PREAMI: Perindopril and Remodeling in Elderly with Acute Myocardial Infarction
Most physicians will recognize the elderly MI survivor with good preserved LV function -- but what is the evidence-based medicine approach to treatment for these patients?
ARTS II: Arterial Revascularization Therapies Study Part II -- The Role of Sirolimus-Eluting Stents in Patients With Unstable Angina
Is the use of a sirolimus-eluting stent in patients with multivessel disease and unstable angina associated with better outcomes than in similar patients with stable angina?
ENDEAVOR I and II: ABT-578-Eluting Stent For the Prevention of Restenosis in Single, De Novo Lesions
Long-term follow-up evaluating the safety and efficacy of the Endeavor ABT-578 drug-eluting stent shows promise against the backdrop of existing data from other drug-eluting stent studies.
JUPITER II: Janus Tacrolimus-Eluting Stent vs Tecnic Carbostent
The use of a new technology specifically designed with reservoirs on the external surface of the stent struts that deliver an antiproliferative agent directly to the vessel wall shows promise, but more data are needed.
IMAGINE: Ischemia Management With Accupril Post Bypass Graft via Inhibition of Angiotensin Converting Enzyme
ACE inhibitors have proven efficacy against ischemia in patients with stable coronary artery disease and stabilized post-CABG -- but what about immediately following CABG?
CIBIS III: Cardiac Insufficiency Bisoprolol Study III
All heart failure patients should be on both ACE inhibitors and beta blockers, but you shouldn't suddenly start both drugs together. So which drug should be prescribed first?
ISSUE 2: International Study of Syncope of Uncertain Etiology 2
The use of an implantable loop recorder is effective at documenting and guiding therapy for neurally mediated syncope, but given the actual probability of this type of syncope, is using the device for this purpose worth it?
S-ICD: Standard Intravenous ICD System With a Totally Subcutaneous ICD System -- Defibrillation Efficacy
The gold-standard of ICDs is a transvenous system, but in this study, a totally subcutaneous system is touted as an effective means to treat patients who may not otherwise need additional pacing features.
Conference News
BNP May Predict LV Dysfunction From High-Dose Chemotherapy 9/8/05
[Medscape Medical News]
There is growing evidence that measuring BNP will allow earlier diagnosis and treatment of heart failure in a variety of settings.
Metabolic Syndrome May Be Independent Risk Factor for CVD 9/8/05
[Medscape Medical News]
A multicenter, case-control study suggests that homocysteine and apolipoprotein B/AI ratio are also independent risk factors for cardiovascular disease.
Women With "Normal" Coronary Arteries Fare Worse Than Men 9/8/05
[Medscape Medical News]
Researchers advocate further and more rigorous investigations in women with angiographically normal coronary arteries; other studies show a gender gap in heart disease management.
Amlodipine-Based Regimen Better Than Atenolol for Hypertension 9/7/05
[Medscape Medical News]
In the ASCOT trial, perindopril added to amlodipine reduced more cardiovascular events than a thiazide added to atenolol, although this might be an effect of BP control.
Thrombolytics Before Angioplasty Associated with Higher Mortality Rates 9/7/05
[Medscape Medical News]
Researchers caution, however, that thrombolytics should not be abandoned altogether.
Pretreatment With Clopidogrel Reduces Cardiovascular Events Before, After PCI 9/6/05
[Medscape Medical News]
Findings from the PCI-CLARITY trial extend the benefits of pretreatment with clopidogrel to a new patient subgroup -- those with recent ST-segment elevation myocardial infarction.
Three Drugs May Beat Two in Acute Coronary Syndromes 9/6/05
[Medscape Medical News]
Adding a glycoprotein IIb/IIIa inhibitor to the standard antiplatelet regimen shows promise in patients with non-ST–segment elevation ACS.
International Perspectives
Developed in collaboration with our international partners.
Canada Canada
ACE Inhibitors for the Treatment of Coronary Artery Disease: A Canadian Local-Thought Leader Perspective From Martin Myers, MD
Do we have all the answers to definitively understand the cardioprotective benefits of angiotensin converting enzyme (ACE) inhibitors in patients with coronary artery disease?

 
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