Medscape Conference Coverage, based on selected sessions at the:
American Heart Association 2005 Scientific Sessions
November 13 - 16, 2005, Dallas, Texas

This activity is not sanctioned by, nor a part of, the American Heart Association.


Also On This Page:Expert InterviewsLate-Breaking Clinical TrialsSession CoverageConference News
Topic Overviews
Highlights of the American Heart Association 2005 Scientific Sessions CME/CE
Physicians - up to 1.0 hour(s) of AMA PRA category 1 credit;
Registered Nurses - up to 1.2 ANCC continuing education contact hours for nurses (1.2 contact hours are in the area of pharmacology)
•AHA 2005: New Data and New Analyses of Old Data Concerning the RAS
Bradford Berk, MD, PhD
•Late-Breaking Clinical Trials on Cholesterol Management From the American Heart Association
Christopher P. Cannon, MD
New Pharmacologic Agents and Other Management Approaches for the Treatment of Atrial Fibrillation
Eric N. Prystowsky, MD
Expert Interviews
Raising HDL-Cholesterol and Reducing Cardiovascular Risk: An Expert Interview With H. Bryan Brewer, Jr, MD
We know that lowering LDL-cholesterol is a therapeutic goal, but is pharmacologically raising HDL also therapeutic? And does inhibiting the cholesteryl ester transfer protein (CETP) accomplish this?
Interaction of Antihypertensive and Lipid-Lowering Therapy in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT): An Expert Interview With Andrew P. Selwyn, MD
ASCOT-LLA and ASCOT-BPLA were both stopped early because the study drugs were so effective. Here Dr. Andrew Selwyn discusses ASCOT 2X2 -- what happened when the 2 arms were statistically combined.
Aggressive Blood Pressure Lowering: Is It the Only Approach? An Expert Interview With Matthew R Weir, MD
Hypertension is still not under control, and the authorities agree that this calls for early and aggressive treatment -- but what is this, in practice? A leading physician explains.
Late-Breaking Clinical Trialss
Lipid Management
IDEAL - Incremental Decrease in Endpoints Through Aggressive Lipid lowering
Following TNT and PROVE IT-TIMI 22, IDEAL adds yet more evidence that for secondary prevention, intensive statin therapy is safe, efficacious, and to be recommended.
CAFE - The Conduit Artery Functional Endpoint Study
The CCB/ACE regimen in ASCOT reduced events significantly more than the beta-blocker/diuretic regimen did, for similar peripheral (brachial) BP reductions. But what were the effects on central aortic BP, and is this the future of BP measurement?
FIELD: Fenofibrate Intervention and Event Lowering in Diabetes
Fenofibrate has a positive effect on every aspect of the lipid profile, but in the statin era, does it have a place, particularly in patients with diabetes?
OmniHeart - Optimal Macronutrient Intake Trial to Prevent Heart Disease
A "healthy diet" is always recommended -- but just what should be the components of such a diet, and what effects will slight variations in the diet have?
ACTIVATE: ACAT IntraVascular Atherosclerosis Treatment Evaluation
ACTIVATE: Is the end of inhibition of acyl-CoA:cholesterol O-acyltransferase (ACAT) as a therapeutic concept?
MEGA: Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese
Do we finally have proof about statin dosing in an at-risk population in Japan?
JELIS - Japan Eicosapentaenoic acid (EPA) Lipid Intervention Study
Fish oil in the diet is thought of as "good," but what about high doses, added to statin therapy, in a population already consuming a high percentage of dietary fish?
PROactive: Proactive Prospective Pioglitazone Clinical Trial In Macrovascular Events -- Subgroup Analysis of Patients With Type 2 Diabetes and Previous Myocardial Infarction
PROactive documented the primary prevention benefits of thiazolidinediones (in this case, pioglitazone) -- but this substudy presents the first evidence-based results in secondary prevention.
Managing High-Risk Populations
REVIVE II and SURVIVE: Use of Levosimendan for the Treatment of Acute Decompensated Heart Failure
Acutely decompensated heart failure patients represent a significant problem for hospital admissions, and it appears that levosimendan may be a welcome addition to treatment for these difficult patients.
ACTIVE W: Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events
Can the addition of clopidogrel to aspirin provide an easy alternative to warfarin for the prevention of stroke and vascular events in AF?
Cell Therapy
REPAIR-AMI: Reinfusion of Enriched Progenitor Cells and Infarct Remodeling in Acute Myocardial Infarction
Can the infusion of autologous bone marrow-derived progenitor cells following successful reperfusion in AMI patients prevent the onset of post-MI heart failure?
ASTAMI: Autologous Mononuclear Bone Marrow Cells in Acute Anterior Wall Myocardial Infarction
Previous studies demonstrated the safety and efficacy of intracoronary injections of bone marrow cells for the treatment of acute MI. Do the results of this study add further weight to the use of this therapy?
PREVENT IV: Edifoligide for the Prevention of Vein Graft Failure in Patients Undergoing Coronary Artery Bypass Surgery
Will blocking the upregulation of gene expression prevent saphenous vein graft failure and occlusion?
Revascularization Strategies
ASSENT-4 PCI: Assessment of the Safety and Efficacy of a New Treatment Strategy for Acute Myocardial Infarction
Does immediate fibrinolysis prior to delayed PCI mitigate the negative impact of that delay and improve clinical outcomes?
EASY: Early Discharge After Transradial Stenting of Coronary Arteries
Is an overnight hospitalization plus 12-hour bolus infusion necessary in patients who undergo uncomplicated transradial PCI, or can they be discharged the same day?
Session Coverage
Lipid Management
Anglo-Scandinavian Cardiac Outcomes Trial -- Lipid Lowering Arm (ASCOT-LLA): Interaction of Antihypertensive and Lipid-Lowering Therapy
In 2002, ASCOT-LLA demonstrated that atorvastatin is protective; in 2005, ASCOT-BPLA showed that CCBs are superior to beta-blockade. Now, a prespecifed analysis of the LLA arm reveals the interaction results.
Phase 2 Studies With Torcetrapib/Atorvastatin Combination
Many, many trials show the benefits of lowering LDL-cholesterol -- but what about the other lipids? Can HDL-cholesterol be concomitantly raised, safely and efficaciously?
Markers of Atherogenic Dyslipidemia: Explaining the Results of PROVE IT - TIMI 22
Is the ratio of apo B/A-I a stronger independent predictor of long-term risk in acute coronary syndromes than the ratio of total cholesterol/HDL? What about CRP?
Statin Treatment Prior to PCI and the Rate of Cardiovascular Events
The results of this meta-analysis suggest that statin pretreatment is associated with fewer adverse cardiac events that extend beyond lipid-lowering properties.
Interaction of Statin Therapy to ACE Inhibitors and ARBs in Post-MI Patients: A Posthoc Analysis of the VALIANT Trial
The results of the VALIANT trial demonstrated that ARBs and ACE inhibitors are equally effective at reducing events in post-MI patients. But does use of statin therapy at baseline modify the treatment effect on these outcomes?
Treating Bifurcation Lesions
Use of a Bifurcation-Dedicated Stent Platform
Could the use of a stent platform dedicated to treating bifurcations overcome some of the technical difficulties associated with treating these complex lesions?
AXXESS Plus Trial: Biolimus A9-Eluting, Self-Expanding, Bifurcated Stent in the Treatment of de Novo Coronary Bifurcation Lesions
Does the use of this drug-eluting stent technology offer promising results for the percutaneous treatment of coronary bifurcation lesions?
Sirolimus-Eluting Stent in Patients With Bifurcation Lesions in Multivessel Coronary Artery Disease: A Substudy of the ARTS II Trial
This substudy examines whether treatment for bifurcation lesions in patients with multivessel coronary artery disease is the next indication for sirolimus-eluting stents.
Paclitaxel- vs Sirolimus-Eluting Stents for the Treatment of Bifurcation Lesions
Which stent was associated with significantly lower rates of late loss, restenosis, and target lesion revascularization?
Managing High-Risk Populations
Drug-Eluting Stents for All Patients With Diabetes?
Is the routine use of drug-eluting stents in diabetic patients justified?
DIABETES Trial Substudy: Sirolimus-Eluting Stent Implantation in Very Small Vessels of Diabetic Patients
The results were as to be expected, but the unexpected result was...
Drug-Eluting Stents vs Bare-Metal Stents in Dialysis Patients: The NHLBI Dynamic Registry
There is limited data on the role of revascularization in patients on dialysis -- namely because outcomes are known to be poor. The current study suggests that the use of drug-eluting stents may improve outcomes in these high-risk patients.
Drug-Eluting Stent Comparisons
Cost-Effectiveness of PCI With or Without Drug-Eluting Stents vs CABG for Treatment of Multivessel CAD: 1-Year Results From ARTS I and II
ARTS II demonstrated that drug-eluting stents were comparable to CABG in patients with multivessel disease in terms of efficacy, but can the same be said for the associated costs?
A "Liberal" Definition of Stent Thrombosis: Sirolimus-Eluting Stent vs Bare Metal Stents
Is the true frequency of stent thrombosis dependent upon the definition used to categorize an event?
SPIRIT FIRST: Durable Polymer Everolimus-Eluting Stent vs Bare Metal Coronary Stent -- 12-Month Results
New stent shows promise, but the system needs to be evaluated in more complex patients.
Cardiac Rhythm Management
PABA CHF: Pulmonary Vein Antrum Isolation vs AV Node Ablation With Biventricular Pacing for Treatment of Atrial Fibrillation in Patients with Congestive Heart Failure
Prior studies have shown that atrioventricular nodal (AVN) ablation with biventricular pacing is superior to AVN ablation with right ventricular pacing. What about pulmonary vein antrum isolation ablation?
SHIELD Substudy: Effects of Azimilide on Electrical Storms in ICD Patients
This SHIELD analysis evaluated the nature and implications of electrical storms in patients undergoing ICD therapy.
Conference News
Dronedarone Efficacious for Control of Atrial Fibrillation, Safer Than Amiodarone 12/1/05
[Medscape Medical News]
The investigational agent decreases mortality and hospitalization rates, and effectively maintains sinus rhythm in patients with atrial fibrillation or flutter.
Aggressive Lipid Lowering Reduces Incidence of Stroke 12/1/05
[Medscape Medical News]
The benefit for stroke reduction is another reason to use statins or high-dose statins in patients at high risk for cerebrovascular events, according to researchers.
Nesiritide-Associated Increase in Serum Creatinine Not Linked to Increase in Mortality in Acute Heart Failure 11/28/05
[Medscape Medical News]
The drug may increase serum creatinine but does not increase mortality in patients with acute decompensated heart failure.
Phase II Data Show Alagebrium Reduces Arterial Stiffness in Elderly With Isolated Systolic Hypertension 11/22/05
[Medscape Medical News]
New drug alagebrium breaks cross-links, reverses the aging process in arteries.
Unfit and Lean Have Fewer Cardiac Risk Factors Than Fit and Fat 11/22/05
[Medscape Medical News]
Weight loss may be more important than fitness in reducing heart risk, according to a cross-sectional study.
Obese Patients May Have Heart Failure at Lower BNP Levels 11/22/05
[Medscape Medical News]
A cut-off of 54 pg/mL could improve the sensitivity of B-type natriuretic peptide measurements in diagnosing heart failure in severely obese patients.
Implantable Monitor Improves Outcomes Among Heart Failure Patients 11/22/05
[Medscape Medical News]
In the COMPASS-HF trial, a hemodynamic monitoring device continuously tracked intracardiac pressure on an outpatient basis.
Decaf Coffee May Increase ApoB Levels 11/21/05
[Medscape Medical News]
Increases in ApoB levels and higher concentrations of nonesterified fatty acids were only observed in individuals who drank decaffeinated -- not caffeinated -- coffee.
Excess Weight Associated With Better Survival in Veterans 11/21/05
[Medscape Medical News]
In the latest evidence of the so-called obesity paradox, researchers have found that overweight and obese veterans have better survival rates than their normal weight counterparts.
Bleeding, Blood Transfusions in ACS Patients More Frequent in US 11/21/05
[Medscape Medical News]
Researchers called on physicians to be more discriminating in the use of blood transfusions and take into account patients' ability to increase blood counts on their own.
Bone Marrow Stem Cell Infusion Safe, Effective for Treatment of Cardiac, Vascular Diseases 11/21/05
[Medscape Medical News]
Early-phase clinical studies with intracoronary infusion of bone marrow stem cells improved ejection fraction and may improve anginal symptoms.
More Intense Exercise, Home-Cooked Meals Curb Childhood Obesity 11/18/05
[Medscape Medical News]
In one study, the slimmest children exercised for about an hour, while the overweight children exercised for 12 fewer minutes.
COX-2 Inhibitors and Other NSAIDs Increase Mortality in Acute MI Patients 11/15/05
[Medscape Medical News]
With the results of the current study, post-MI patients should not use COX-2 inhibitors and they should use nonsteroidal anti-inflammatory drugs only at low doses.
Almost Half of Cardiac Patients Use Alternative Medicines 11/15/05
[Medscape Medical News]
Researchers called on physicians to take a more active role in both asking and educating their patients about alternative medicine use.
Fish Oil Supplements Improve Lipid Risk Factors in Obese Children 11/14/05
[Medscape Medical News]
In a small, randomized study, triglyceride levels decreased and HDL cholesterol levels increased; total cholesterol/HDL and total cholesterol/LDL ratios also improved.

 
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