4 / 32
ACC 2016
2–4 APRIL 2016 •
CHICAGO, USA
The American College of
Cardiology’s 65th Annual
Scientific Session & Expo
saw the presentation of
key studies such as the
PARTNER 2, PROMISE,
HOPE-3, INOVATE-HF
and FIRE AND ICE
trials.
PracticeUpdate
Cardiology
Editorial
Board members Dr Joerg
Herrmann and Dr Doug
Zipes discuss their top
abstracts fromACC 2016.
Dr Joerg Herrmann discusses
PARTNER 2, HOPE-3,
DANAMI-3 DEFER, Early-BAMI
and STITCH Extension studies
Joerg Herrmann MD is Assistant Professor of Medicine, Mayo
Graduate School of Medicine, and
PracticeUpdate Cardiology
Editorial Board member. He presents his top abstracts, and their
take-home message, from ACC 2016.
Session 401:
Opening showcase and the
joint ACC/
JACC
late-breaking clinical trials
featuring the Simon Dack lecture
Transcatheter aortic valve replacement compared
with surgery in intermediate risk patients with
aortic stenosis: final results from the randomised
Placement of Aortic Transcatheter Valves 2 study.
MB Leon, C Smith, M Mack, et al
•
In the PARTNER 2 trial, researchers
randomised 2032 patients with aortic stenosis
and an intermediate risk for surgery to undergo
transcatheter aortic valve replacement (TAVR)
or surgical aortic valve replacement. Assigned
vascular access was mainly transfemoral
(76.3%). The rate of death from any cause
or disabling stroke was similar between
the groups; however, when assessing the
transfemoral access cohort only, the researchers
found that TAVR was associated with a lower
rate of death or disabling stroke than surgery
(P = 0.05). Overall, surgery was associated
with fewer major vascular complications and
less paravalvular aortic regurgitation, and TAVR
was associated with less kidney injury, severe
bleeding, and new-onset atrial fibrillation.
•
Researchers concluded that TAVR is associated
with similar rates of death and disabling
stroke when compared with surgery among
intermediate-risk patients.
Blood pressure lowering in people at moderate
risk. The HOPE-3 trial.
EM Lonn
•
In the HOPE-3 trial, researchers
randomised 12,705 patients with moderate
cardiovascular risk to evaluate candesartan/
hydrochlorothiazide vs placebo for the primary
prevention of cardiovascular events. In patients
receiving candesartan/hydrochlorothiazide,
there was a greater decrease in blood pressure
(6.0/3.0 mmHg) than in the placebo group. At
baseline, mean blood pressure was 138.1/18.9
mmHg. The rate of cardiovascular death and
events was significantly lower among patients
with a systolic blood pressure >143.5 mmHg
receiving active treatment. Overall, the rate of
cardiovascular death and events were similar
between groups.
•
In patients with an intermediate risk for
cardiovascular disease, researchers concluded
that lowering blood pressure with candesartan/
hydrochlorothiazide was not associated with
fewer major cardiovascular events than placebo.
Effects of rosuvastatin on cardiovascular disease
in moderate risk primary prevention in diverse
ethnic groups.
J Bosch
•
In the HOPE-3 trial, researchers randomised
12,705 patients with moderate risk for
cardiovascular disease to evaluate rosuvastatin
vs placebo for the primary prevention of
cardiovascular events. In patients receiving
rosuvastatin, there was a greater decrease
in LDL (26.5%) than in patients receiving
placebo. Rosuvastatin was also associated
with fewer cardiovascular deaths and events
than placebo (P = 0.002 and P < 0.001,
respectively). Muscle symptoms were more
common in the rosuvastatin group.
•
In patients with an intermediate risk for
cardiovascular disease, researchers concluded
that rosuvastatin was associated with fewer
major cardiovascular events than placebo.
Effects of combined lipid and BP-lowering on
cardiovascular disease in a moderate risk global
primary prevention population.
S Yusuf
•
In the HOPE-3 trial, researchers randomised
12,705 patients with moderate risk for
cardiovascular disease to receive candesartan/
hydrochlorothiazide, rosuvastatin, or placebo
in combination or alone. In patients receiving
combined blood pressure and lipid-lowering
therapy, there was a greater decrease in LDL
(33.7 mg/dL) and a greater decrease in systolic
blood pressure (6.2 mmHg) than in patients
receiving dual placebo. The combined-therapy
group also had significantly lower rates of
PRACTICEUPDATE CARDIOLOGY
AMERICAN COLLEGE OF CARDIOLOGY SCIENTIFIC SESSIONS
4