Cardiology News / Recent Literature Review / Third Quarter 2020

Cardiology News

Abstract

Rhythmos 2020;15(4):80-87.  

TCT/ Virtual Event: 14-18/10/2020

HCS/Panhellenic (41^st) Congress of Cardiology: Athens, 22-24/10/2020

AHA Meeting 2020: cancelled

ACC Meeting: Atlanta, 20-22/3/2021

EHRA Meeting: Barcelona, 28-30/3/2021

COMPASS Trial: Rivaroxaban 2.5 mg bid Plus ASA vs ASA Alone Resulted in Fewer Events (Stroke and Cardiovascular Mortality), Particularly in High-Risk Subgroups and Those With Multiple Risk Characteristics With Less Frequent Severe Bleedings and Less Clinical Impact

Rivaroxaban 2.5 mg bid plus aspirin 100 mg reduced the risk of cardiovascular (CV) events as compared with ASA monotherapy in the COMPASS trial but increased the risk of major bleedings. The current prespecified analysis was performed to assess the net clinical benefit (NCB) of adding rivaroxaban 2.5 mg bid to ASA monotherapy in patients with chronic vascular disease in the COMPASS study cohort with a specific focus on high-risk subgroups. A lower number of NCB adverse outcomes was observed with rivaroxaban 2.5 mg bid plus ASA vs ASA alone (hazard ratio, 0.80, P=0.0005), which became increasingly favorable with longer treatment duration. In selected high-risk subgroups, a larger absolute risk reduction for experiencing a NCB event was observed (Steffel J et al, Circulation 2020; 142:40-48).

COVID-19: The Prevalence of DVT is High, Associated With Adverse Outcomes in Hospitalized Patients With COVID-19 / Prophylaxis for DVT May be Protective in Patients With a Padua Protection Score ≥4 After Admission

Of the 143 patients hospitalized with COVID-19 (age 63±14 years, 51.7% men), 66 patients developed lower extremity DVT (46.1%). Compared with patients who did not have DVT, patients with DVT were older and had a lower oxygenation index, a higher rate of cardiac injury, and worse prognosis, including an increased rate of deaths (34.8% vs 9 11.7%; P=0.001) and a decreased proportion of patients discharged (48.5% vs 77.9%; P<0.001). In the subgroup of patients with a Padua prediction score ≥4 and whose ultrasound scans were performed >72 h after admission, DVT was present in 34% patients in the subgroup receiving thromboprophylaxis vs 66% patients in the nonprophylaxis group (P=0.010) (Zhang L et al, Circulation 2020; 142:114–128).

Meta-Analysis: Prasugrel and Ticagrelor Reduced Ischemic Events and Increased Bleeding Compared With Clopidogrel in Patients with ACS / A Significant Mortality Reduction Was Observed With Ticagrelor Only /There was no Efficacy and Safety Difference Between Prasugrel and Ticagrelor

According to a network meta-analysis of 12 RCTs including 52 816 patients with acute coronary syndrome (ACS), in comparison with clopidogrel, ticagrelor significantly reduced cardiovascular mortality (hazard ratio-HR, 0.82) and all-cause mortality (HR, 0.83), with no significant mortality reduction with prasugrel (HR, 0.90 and HR, 0.92, respectively). In comparison with each other, there were no significant differences in mortality. In comparison with clopidogrel, prasugrel reduced myocardial infarction (HR, 0.81), whereas ticagrelor showed no risk reduction (HR, 0.97). Differences between prasugrel and ticagrelor were not significant. Stent thrombosis risk was significantly reduced by both ticagrelor and prasugrel versus clopidogrel (28%–50% range of reduction). In comparison with clopidogrel, both prasugrel (HR, 1.26) and ticagrelor (HR, 1.27) significantly increased major bleeding. There were no significant differences between prasugrel and ticagrelor for all outcomes explored (Navarese EP et al, Circulation. 2020;142:150–160)... (excerpt)