Cardiology News / Recent Literature Review / First Quarter 2018

Abstract

Manolis AS, Anninos H. Cardiology News / Recent Literature Review / First Quarter 2018. Rhythmos 2018;13(2):38-43.

HRS Meeting: Boston, 9-12/5/2018

EuroPCR Meeting: Paris, 22-25/5/2018

ESC Meeting: Munich, 25-29/8/2018

ICD in Children & Adolescents with Brugada Syndrome: ~1 in 4 Patients Receive Appropriate Life-Saving Interventions Over a Period of 7 Years, Although Inappropriate Shocks and Other Adverse Events Occur Relatively Frequently

 Among 35 consecutive patients (aged 13.9±6.2 years). over a mean of 88 months, sustained ventricular arrhythmias were treated by the ICD in 9 patients (26%), including shocks in 8 (23%) and antitachycardia pacing in 1 patient (3%). Three patients (9%) died in an electrical storm. Seven patients (20%) experienced inappropriate shocks, and 5 (14%) had device-related complications. Aborted sudden cardiac death and spontaneous type I ECG were identified as independent predictors of appropriate shock occurrence (Gonzalez Corcia MC et al, J Am Coll Cardiol 2018;71: 148–57).

Cardiomyopathy (CM) Patients With LVEF≤35% and LBBB Demonstrate Significantly Less LV Functional Recovery With Medical Therapy Than Do Those With a Narrow QRS / Thus, They Would Benefit From Earlier Implantation of a CRT Device

Among 659 patients with CM, 111 having LBBB (17%), 59 wide QRS duration ≥120 ms but not LBBB (9%), and 489 narrow QRS duration (74%), adjusted mean increase in LVEF over 3-6 months in the 3 groups was 2.03%, 5.28%, and 8%, respectively (p<0.0001), with no different results for interim revascularization and myocardial infarction. The combined endpoint of heart failure hospitalization or mortality was highest for patients with LBBB (Sze et al, J Am Coll Cardiol 2017;71: 306-17).

1-Year Follow-Up of PRAGUE-18 Study: Among Patients With MI Undergoing Primary PCI, Antiplatelet Therapy With Prasugrel or Ticagrelor is Associated With Similar Outcomes / Economically Motivated, Early Post-Discharge Switch To Clopidogrel was not Associated With Increased Risk of Ischemic Events 

Among 1,230 patients with acute myocardial infarction (MI) treated with primary PCI and randomized to prasugrel or ticagrelor, the endpoint (cardiovascular death, MI, or stroke at 1 year) occurred in 6.6% of prasugrel patients and in 5.7% of ticagrelor patients (hazard ratio: 1.167; p = 0.503). No significant differences were found in: CV death (3.3% vs 3%), MI (3% vs. 2.5%), stroke (1.1% vs 0.7%), all-cause death (4.7% vs. 4.2%), definite stent thrombosis (1.1% vs. 1.5%), all bleeding (10.9% vs. 11.1%), and TIMI major bleeding (0.9% vs. 0.7%). The percentage of patients who switched to clopidogrel for economic reasons was 34.1% (n=216) for prasugrel and 44.4% (n=265) for ticagrelor (p=0.003). Patients who were economically motivated to switch to clopidogrel had (compared with patients who continued the study medications) a lower risk of major CV events; however, they also had lower ischemic risk (Motovska Z et al, J Am Coll Cardiol 2018;71:371-81)... (excerpt)