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cardiovascular death and events (P =
0.005 and P = 0.003, respectively). Adverse
events associated with combined therapy
included muscle weakness and dizziness.
•
In patients with an intermediate risk
for cardiovascular disease, researchers
concluded that combined blood pressure
and lipid-lowering therapy is associated with
fewer cardiovascular events than placebo.
Session 405:
Joint American College
of Cardiology/TCT late-breaking
clinical trials
The Third DANish Study of Optimal Acute
Treatment of Patients with ST-segment
Elevation Myocardial Infarction: DEFERred
stent implantation in connection with primary
PCI.
H Kelbæk, L Kober, S Helqvist, et al
The Third DANish Study of Optimal Acute
Treatment of Patients with ST-segment
Elevation Myocardial Infarction: iPOST
conditioning during primary PCI.
T Engstrøm,
H Kelbæk, S Helqvist, et al
•
Stent implantation can result in thrombotic
embolisation; therefore, in the DANAMI-3
DEFER trial, researchers randomised
1215 patients with ST-segment elevation
myocardial infarction to undergo
standard primary percutaneous coronary
intervention (PCI) with stent implantation
or deferred stent implantation. They
did not find differences in death, heart
failure, myocardial infarction, or repeat
revascularisation.
•
Researchers concluded that deferred stent
implantation resulted in similar outcomes
to standard PCI procedure.
Effect of early administration of intravenous
beta blockers in patients with ST-elevation
myocardial infarction before primary percuta-
neous coronary intervention. The Early-BAMI
trial.
V Roolvink, B Ibanez, JP Ottervanger, et al
•
The use of beta blockers before primary
PCI is not well studied; therefore, in the
Early-BAMI trial, researchers randomised
683 patients with ST-segment elevation
myocardial infarction (STEMI) to receive
intravenous metoprolol or placebo before
PCI. The mean age was 62 years, and
majority of patients were male (75%).
Researchers did not find a significant
difference in infarct size between the
groups or in the rate of adverse events. The
metoprolol group had a lower incidence of
malignant arrhythmias than the placebo
group (3.6% vs 6.9%, respectively; P = 0.05).
•
Metoprolol administered before primary
PCI did not reduce infarct size when
compared with placebo among patients
with STEMI.
Session 406:
Featured clinical
research I: interventional cardiology
and surgery
Ten-Year outcome of coronary artery bypass
graft surgery versus medical therapy in
patients with ischemic cardiomyopathy:
Results of the Surgical Treatment for Ischemic
Heart Failure Extension study.
EJ Velazquez,
KL Lee, RH Jones, et al
•
In the STICH Extension study, researchers
evaluated the 10-year survival of coronary
artery bypass grafting (CABG) with medical
therapy versus medical therapy alone in
patients with ischaemic cardiomyopathy.
A total of 1212 patients were randomised.
The rate of death from any cause was
significantly higher inmedical therapy group
than in the CABG group (66.1% vs 58.9%,
respectively; P = 0.02). Cardiovascular
mortality was also higher in the medical
therapy group than in the CABG group
(49.3% vs 40.5%, respectively; P = 0.006).
•
After 10-year follow-up, results showed
that CABG plus medical therapy was
associated with lower rates of death and
cardiovascular events than medical therapy
alone among patients with ischaemic
cardiomyopathy.
© 2016 Lagniappe Studio
DECEMBER 2016
ACC 2016
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