Medscape Conference Coverage, based on selected sessions at the:

American Heart Association (AHA) 2007 Scientific Sessions

November 04 - 07, 2007; Orlando, Florida

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

Conference Coverage

The Failure of Torcetrapib -- The Search for the Reason Why

Why did torcetrapib fail? Was it the blood pressure? The electrolytes? New data from ILLUMINATE and ILLUSTRATE, and new CETP inhibitors suggest answers.
The COURAGE Trial: The Controversy Continues

A closer examination of the COURAGE trial results suggest PCI may in fact be a good strategy in patients with stable angina…or does it only confuse things more?
Why Patients Stop Taking Statins and What Can Be Done About It

Coronary heart disease is almost an epidemic, but fortunately statin therapy is largely very effective and safe -- except that many patients stop taking their prescribed statin. Who and why?
Adjunctive Therapy in ACS Patients: TRITON-TIMI 38, EVA-AMI, and BRIEF-PCI

Prasugrel vs clopidogrel, eptifibatide vs abciximab in primary PCI, and brief vs standard infusions of GP IIb/IIIa inhibition after nonemergent PCI in ACS patients are described.

Conference News

DES for Intracranial Stenosis?

A first look at just under 100 patients who received drug-eluting stents for significant intracranial stenosis shows that their use appears to be feasible in this indication, and they seem to be safe and produce more favorable outcomes than medical therapy or bare metal stents. However, further randomized trials are needed, say the researchers. Heartwire, November 21, 2007
Vernakalant for AF Post-CABG, Valve Surgery

Results of the ACT II study suggest that the investigational antiarrhythmic may help almost half of all patients who develop atrial fibrillation or flutter after CABG or valve surgery. Heartwire, November 16, 2007
Folic Acid Cuts Congenital Disease

Public-health measures to increase folic-acid intake in Canada were followed by a decrease in the prevalence of severe congenital heart disease at birth, supporting the hypothesis that folic acid has a preventive effect on this outcome, researchers say. Heartwire, November 16, 2007
Percutaneous Valve Results for 100 Patients

The series points to the steep learning curve with the Edwards Sapien valve and lower-than-expected mortality rates. Heartwire, November 14, 2007
Nicotine Vaccine

A phase 2 study of a nicotine vaccine has shown that the highest dose tested produced antibodies against nicotine and was associated with a higher rate of smoking cessation than placebo. Heartwire, November 13, 2007
MASCOT: No Routine AF Suppression During CRT

The incidence of new chronic atrial fibrillation was low in the trial and was the same whether or not the CRT device's AF-suppression function was activated. Heartwire, November 13, 2007
STEMI Care in NC

Researchers in North Carolina have instituted one of the largest and most extensive programs in the US to improve the treatment of STEMI, demonstrating significant improvements in quality of care. But there is still much work to be done. Heartwire, November 12, 2007
Lagging Numbers of Women in CVD Trials

Investigators say the paucity of women in trials means not only missing information but potentially putting women at risk. Heartwire, November 9, 2007
RethinQ CRT in Narrow-QRS Patients

Cardiac resynchronization therapy didn't improve functional outcomes among patients with a QRS duration <130 msec in the small randomized trial. Heartwire, November 7, 2007
MASTER I: Disappointment for T-Wave Alternans Testing

The test did not predict life-threatening ventricular tachyarrhythmic events in patients with MADIT-2 criteria for ICD implantation and therefore should not be used to stratify ICD use in this group, researchers said. Heartwire, November 7, 2007
Cardiac Stem-Cell Results Highlight Need to Standardize and Collaborate

Results from three new studies offer a glimpse of progress, but experts say the field needs to retrace its steps; understand the fundamental biology; and reach some consensus about what cells to use, how they're delivered, and when they should be used. Heartwire, November 7, 2007
Genetic Guidance of Warfarin Dosing

Using genetic tests improved the accuracy and efficiency of warfarin dose initiation in the Couma-Gen study, but the primary end point of a reduction in out-of-range INRs was not significantly changed. Heartwire, November 7, 2007
Hypertension Vaccine Safe, Well-Tolerated in Phase 2a Study

Results of a phase 2a study suggest that an investigational vaccine against angiotensin II was safe and well-tolerated in patients with mild to moderate hypertension. Preliminary data also indicate good blood pressure control with the vaccine for up to 4 months. Medscape Medical News, November 6, 2007
AED Use by Bystanders Improves Survival in Out-of-Hospital Cardiac Arrest

A review of out of hospital cardiac arrests in 11 cities in the United States and Canada shows an impressive increase in survivors with the public availability of automated external defibrillators. Medscape Medical News, November 6, 2007
New Interest in CETP Inhibitors

New data from the ILLUMINATE and ILLUSTRATE trials have shown that torcetrapib stimulates aldosterone, which possibly accounts for its adverse outcomes. In addition, both studies showed that patients with the largest HDL increases with the drug showed benefits, suggesting that the HDL produced was functional. Heartwire, November 6, 2007
What Role for Prasugrel?

The predominant view on the trial appears to be that prasugrel probably does have a role in clinical practice, as long as care is taken in certain patient groups at high risk of bleeding. Heartwire, November 6, 2007
CORE 64: CTA Diagnostics and Debate

Dr Michael Lauer is calling for a moratorium on CT angiography pending outcomes studies. But investigators for the CORE 64 trial say studies demonstrating diagnostic capabilities of CTA are important baby steps toward slashing unnecessary, invasive tests. Heartwire, November 6, 2007
COURAGE Substudy Supports PCI for Ischemia Relief in Stable CAD

It's old school, and yet. . . . A substudy of the trial that sparked a reevaluation of PCI for patients with stable coronary disease confirmed what has been long observed, that PCI on top of medical therapy is better than meds alone at reducing myocardial ischemia. Whether better ischemia relief means better clinical outcomes is still up in the air. Heartwire, November 5, 2007
EVA-AMI: Eptifibatide in STEMI PCI

The results will be reassuring to cath labs already substituting the cheaper GP IIb/IIIa inhibitor in STEMI patients, but at least one expert believes proof of equivalence for two GP IIb/IIIa inhibitors does not answer the question of whether these agents should be widely in use for STEMI patients. Heartwire, November 5, 2007
Massachusetts DES: Safe and Effective

At two years, DES were associated with comparable MI rates but statistically significant reductions in mortality and revascularizations. Investigators say they will continue to track the 17 000+ patients for at least five years, but for now the findings are "reassuring." Heartwire, November 5, 2007
BRIEF-PCI Impresses

A shortened, two-hour infusion of the GP IIb/IIIa inhibitor eptifibatide following nonemergency PCI is just as effective as the standard 18-hour infusion of the drug and is probably safer, according to a new study. Heartwire, November 5, 2007
QoL, Economic Data From OAT

Further quality-of-life and economic analysis of the Occluded Artery Trial support and reinforce the original conclusions of the study--that it is best to treat stable post-MI patients with optimal medical therapy alone rather than PCI. Heartwire, November 5, 2007

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