MedPage Today | ESC Congress 2019

ACC Conference Reporter

ESC Congress 2019 | Paris, France

September 3, 2019
Beta-Blockers Increase Survival for HF Patients With Renal Impairment
PARIS — Beta-blockers may benefit patients with moderate renal impairment and heart failure (HF) by reducing mortality, the BB-meta HF trial found.

September 3, 2019
Aggressive Vasodilation Flops in Acute Heart Failure
PARIS — Early intensive and sustained vasodilation failed to improve outcomes in acute heart failure, a randomized trial found.

September 3, 2019
ICDs Still Save Lives in HF
PARIS — Implantable cardioverter-defibrillators (ICDs) continue to have a primary prevention survival benefit in the modern era of heart failure treatment but are still underused, a Swedish study suggested.

September 3, 2019
SYNTAX at 10 Years: Bypass vs PCI Still a Toss-Up Overall
PARIS — With outcomes data spanning over a decade, an extension study of SYNTAX confirmed that certain patients with complex coronary lesions get different benefits from coronary artery bypass grafting (CABG) and stenting.

September 3, 2019
Precision Medicine Lowers DAPT Bleeds in STEMI
PARIS — Selection of P2Y12 inhibitors based on genetic variants that influence response reduced bleeding events without hurting outcomes in ST-segment elevation MI (STEMI) patients getting stented, the POPular Genetics trial showed.

September 3, 2019
PARIS — Bayesian statistics allowed researchers to pick a winner between two new-generation drug-eluting stents (DES) compared in a randomized trial powered for superiority.

September 3, 2019
Salt Substitute Shakes Up Hypertension in Community Trial
PARIS — A community-wide salt substitution intervention improved blood pressure and hypertension control levels, a pragmatic trial from Peru showed.

September 3, 2019
LDL, BP Combine Forces Like 'Pack-Years' for the Arteries
PARIS — Blood pressure and cholesterol have independent effects that add up in a dose-dependent manner akin to the concept of cigarette "pack-years," a mendelian randomization study found.

September 2, 2019
Antiplatelets Go Head-to-Head in ACS, With Unexpected Result
PARIS — In a large head-to-head trial of two P2Y12 Inhibitors, prasugrel (Effient) significantly lowered rates of ischemic events versus ticagrelor (Brilinta) for patients with acute coronary syndrome (ACS), and without an increase in major bleeds.

September 2, 2019
NOAC Best Given Alone for Afib With Stable Heart Disease
PARIS — Adding an antiplatelet to rivaroxaban (Xarelto) for atrial fibrillation in stable coronary artery disease may backfire, the Japanese AFIRE trial affirmed.

September 2, 2019
Bariatric Surgery Tied to Better Cardiometabolic Health Down the Road
PARIS — On top of helping obese patients with diabetes achieve their short-term weight and glycemic goals, bariatric surgery may be linked to improved overall cardiometabolic health years later, a retrospective cohort study found.

September 2, 2019
Community Health Workers Slinging Free Heart Drugs Cut CV Risks
PARIS — A tailored community-based intervention that leaned on the various skills of non-physician health workers (NPHWs) cut the risk of cardiovascular disease in patients with high blood pressure, results of the HOPE 4 trial showed.

September 2, 2019
Routine High-Flow Oxygen: Still Warranted for STEMI?
PARIS — Routine supplemental oxygen didn't help those with suspected acute coronary syndrome, with the possible exception of hypoxic ST-segment elevation MI (STEMI) patients, the NZOTACS trial showed.

September 2, 2019
MITRA-FR Inches in Line With COAPT at 2 Years Despite Contradictory Findings
PARIS — Percutaneous repair with the MitraClip still adds no benefit to the treatment of patients with secondary mitral regurgitation (MR) in the MITRA-FR trial, according to follow-up data extending out to 2 years.

September 2, 2019
Big Cuts in LDL Possible With Twice-Yearly Injections
PARIS — In patients with atherosclerotic cardiovascular disease (ASCVD), LDL cholesterol was halved with a twice-a-year regimen of injectable small interfering RNA (siRNA) that inhibits the PCSK9 protein, according to the ORION-11 trial presented here.

September 1, 2019
COMPLETE Revascularization Gets Its Win for Hard Outcomes
PARIS — Making complete revascularization the routine goal of percutaneous coronary intervention (PCI) conferred a benefit in hard outcomes for ST-segment myocardial infarction (STEMI) patients with multivessel disease, according to the COMPLETE trial.

September 1, 2019
Extended DAPT with Brilinta: No Benefit for Stable CAD in T2D
PARIS — Ticagrelor (Brilinta) as part of a dual antiplatelet therapy (DAPT) regimen didn't improve net outcomes for stable coronary artery disease (CAD) among type 2 diabetes patients, except perhaps in the setting of percutaneous coronary intervention (PCI), the THEMIS trial showed.

September 1, 2019
Risk-Based Thresholds for hs-Troponin I Safely Speed MI Rule-Out
PARIS — Using different cutoffs for high-sensitivity cardiac troponin I (hs-cTnI) testing based on risk accurately ruled out MI and sent patients home from the emergency department sooner without missing adverse cardiac events, the HISTORIC trial found.

September 1, 2019
'Most Promising' Cardioprotective Strategy Ends Up a Bust
PARIS — Remote ischemic preconditioning failed as a cardioprotective strategy for patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation MI (STEMI), according to the CONDI-2/ERIC-PPCI trial presented here.

September 1, 2019
Dapagliflozin Benefits HFrEF Outcomes, Even Without Diabetes
PARIS — Dapagliflozin (Farxiga) lowered the risk of cardiovascular death and decompensation, and improved symptoms in heart failure (HF) with reduced ejection fraction (HFrEF), the DAPA-HF trial found.

September 1, 2019
Entresto Signals Expansion Into 'Gray Zone' of HFpEF
PARIS — Sacubitril/valsartan (Entresto) struck out on heart failure with preserved ejection fraction (HFpEF) in the PARAGON-HF trial but signaled benefit in the lower range of EF.

August 31, 2019
Inflammatory Markers Add to TAVR Risk Stratification
PARIS — Certain inflammatory leukocyte and marker levels may aid in risk prediction for transcatheter aortic valve replacement (TAVR) candidates, new research suggests.

August 31, 2019
PCSK9 Drug Jump-Starts LDL Lowering In-Hospital After ACS
PARIS — Adding a PCSK9 inhibitor to high-intensity statin treatment early after an acute coronary syndrome (ACS) -- before hospital discharge -- was safe and more effectively lowered LDL levels, the phase III EVOPACS trial found.

August 31, 2019
Drive LDL as Low as Possible, ESC Says
PARIS — LDL cholesterol levels should be driven as low as possible, especially in high-risk patients, according to new European guidelines that tighten down treatment targets.

August 29, 2019
Ticagrelor, HF Treatment in the Spotlight at ESC
PARIS — As the European Society of Cardiology meeting kicks off this weekend in the City of Light, the limelight falls to the THEMIS trial of ticagrelor for secondary prevention in type 2 diabetes and the heart failure trials PARAGON-HF and DAPA-HF.

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Keywords: ESC Congress, ESC 19

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