Cardiology News /Recent Literature Review / Second Quarter 2013

Abstract

ESC Congress will be held in Amsterdam, 31/8-4/9/13

 HCS Meeting: Athens, 10-12/10/2013

 TCT Meeting: San Francisco, 28/10-1/11/13

 AHA 2013: Dallas, 16-20/11/13  

 ACC 2014: Washington, DC, 29-31/3/2014

 Athens Cardiology Update 2014: Athens (Crown Plaza Hotel), 10-12/4/2014

 HRS Meeting: San Francisco, 7-10/5/2014

 EuroPCR: Paris, 20-23/5/2014

 CardioStim 2014: Nice, 18-21/6/2014

 ARMYDA-9 CAROTID: Clopidogrel Load & Atorvastatin Reload Prevent Ischemic Cerebral Events After Protected Carotid Stenting

A total of 156 patients undergoing protected carotid stenting were randomized to a 600-mg (n=78) or 300-mg (n=78) clopidogrel load given 6 h before intervention and either an atorvastatin reload (n=76; 80 mg + 40 mg initiating 12 h before the procedure) or no statin reload (n=80). Occurrence of the primary outcome (30-day incidence of TIA/stroke or new ischemic lesions on cerebral MRI performed at 24-48 h) was lower in the 600-mg clopidogrel arm (18% vs. 35.9% in the 300-mg group; p = 0.019) and in the atorvastatin reload arm (18.4% vs 35.0% in the no statin reload group; p=0.031). High-dose clopidogrel also significantly reduced the TIA/ stroke rate at 30 days (0% vs 9%, p = 0.02), without an increase in bleeding risk. The authors concluded that in patients undergoing carotid stenting, a 600-mg clopido-grel load and a short-term reload with high-dose atorva-statin protects against early ischemic cerebral events (Patti G et al, J Am Coll Cardiol 2013;61:1379-1387)

 MADIT CRT: Carvedilol Produces 30% Reduction in Hospitalizations for HF or Death When Compared With Metoprolol

The effects of metoprolol and carvedilol were compared in the MADIT-CR study. Hospitalization for HF or death occurred in 23% on carvedilol and 30% on metoprolol (hazard ratio-HR: 0.70, p=0.001), further attenuated in the subgroup of CRT-D patients (HR: 0.61, p = 0.001) and CRT-D patients with LBBB (HR: 0.51, p < 0.001). Ventricular arrhythmias occurred in 22% and in 26%, respectively, of the patients receiving carvedilol or metoprolol (HR: 0.80, p = 0.050). A dose-dependent relationship was found in carvedilol, but not in metoprolol. The authors concluded that in HF patients in NYHA class I/II & wide QRS, carvedilol was associated with a 30% reduction in hospitalizations for HF or death when compared with metoprolol. A novel beneficial and synergistic effect of carvedilol was seen in patients with CRT-D & LBBB. Finally, a dose-dependent effect was apparent in carvedilol, but not in metoprolol (Ruwald et al, J Am Coll Cardiol 2013;61:1518–1526)... (excerpt)