Cardiology News / Recent Literature Review / Third Quarter 2021
TCT Meeting, San Francisco, 22-26/10/2021
42ndPanhellenic Congress of Cardiology, Athens, 21-23/10/21
AHA Sessions 2021, Boston, MA, USA, 13-15/10/21
ACC.22, Washington, DC, USA, 2-4/4/22
EuroPCR, Paris, France, 17-20/5/22
Subanalysis of SYNTAXES: In Patients With 3-Vessel and/or Left Main Disease Having PCI or CABG, Those on Optimal Medical Therapy (OMT) at 5 Years Had a Survival Benefit at 10 Years
Among 1472 patients, patients on OMT at 5 years had a significantly lower mortality at 10 years compared with those on ≤2 types of medications (13.1% vs 19.9%; adjusted HR: 0.470; P=0.002) but had a mortality similar to those on 3 types of medications. Patients having CABG with antiplatelet drug and statin at 5 years had lower 10-year mortality than those without (Kawashima H et al, J Am Coll Cardiol 2021;78:27-38).
GALACTIC-HF: In Heart Failure (HF) Patients with Reduced Ejection Fraction (EF), Omecamtiv Mecardil Conferred Greater Benefit as Baseline EF Decreased
The risk of the primary composite endpoint (PCE) of time-to-first HF event or CV death in the placebo group was ~1.8-fold greater in the lowest EF (≤22%) vs the highest EF (≥33%) quartile. Amongst the pre-specified subgroups, EF was the strongest modifier of the treatment effect of omecamtiv mecarbil on the PCE (P=0.004). Patients receiving omecamtiv mecarbil had a progressively greater relative and absolute treatment effect as baseline EF decreased, with a 17% relative risk reduction for the PCE in patients with baseline EF≤22% (n=2,246; HR 0.83) vs patients with EF ≥33% (n=1,750; HR 0.99; P=0.013). The absolute reduction in the PCE increased with decreasing EF (EF≤22%; risk reduction, 7.4 events per 100 patient-years; number needed to treat for 3 years = 11.8), compared with no reduction in the highest EF quartile (Teerlink JR et al, J Am Coll Cardiol 2021;78:97-108).
Repurposing Metoprolol for COVID-19-Associated ARDS Appears a Safe and Inexpensive Strategy that Can Alleviate the Burden of the COVID-19 Pandemic
Among 20 COVID-19 patients with ARDS on invasive mechanical ventilation randomized to metoprolol (n=12, 15 mg daily for 3 days) or control (n=8, no treatment), patients randomized to metoprolol had significantly fewer neutrophils in bronchoalveolar lavage (BAL) on day 4 (P=0.016). Metoprolol also reduced neutrophil extracellular traps content and other markers of lung inflammation. Oxygenation (PaO2:FiO2) significantly improved after 3 days of metoprolol treatment (P=0.003), whereas it remained unchanged in control subjects. Metoprolol-treated patients spent fewer days on invasive mechanical ventilation than those in the control group (15.5±7.6 vs 21.9±12.6 days; P=0.17) (Clemente-Moragon A et al, J Am Coll Cardiol 2021;78:1001-11)... (excerpt)
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