Intro: The HOPE-3 trial (Heart Outcomes Prevention Evaluation–3) found that antihypertensive therapy combined with a statin reduced the first stroke among people at intermediate cardiovascular risk. In this study, secondary analyses of predefined stroke outcomes for each randomized intervention, was reported by stroke subtype, independent predictors, treatment effects in key subgroups, and absolute risk reductions. Methods: Using a 2-by-2 factorial design, 12 705 participants from 21 countries w...
Oct 04, 2021•4 min•Season 1Ep. 21
In a Hot Line session today, Professor Steffen (Germany) presented results from the large randomized, open-label TOMAHAWK trial, which undertook to provide a definitive position on the use of early angiography in patients with shockable or non-shockable rhythm. The trial randomized 554 patients with return of spontaneous circulation after OUT OF HOSPITAL CARDIAC ARREST with no obvious extracardiac origin of cardiac arrest and no ST-segment elevation/left bundle-branch block on post-resuscitation...
Sep 06, 2021•3 min•Season 1Ep. 20
STEP study, presented by Professor Jun Cai (Chinese Academy of Medical Sciences, Beijing, China) in a Hot Line session on 30th August. The STEP study investigated whether intensive treatment (systolic blood pressure [SBP] target below 130 mmHg but no lower than 110 mmHg) could reduce the risk of cardiovascular (CV) events compared with standard treatment (SBP target 130–150 mmHg). In total, 8,511 patients aged 60–80 years with SBP 140–190 mmHg during three screening visits or who were taking ant...
Sep 06, 2021•3 min•Season 1Ep. 19
In a Hot Line session of 28th August, Professor Marco from Switzerland presented results from the investigator-initiated, open-label MASTER DAPT trial comparing an abbreviated vs. a standard duration of antiplatelet therapy after bioresorbable polymer-coated sirolimus-eluting stent implantation in patients with acute or chronic coronary syndrome who fulfilled one or more high bleeding-risk criteria. Following a mandatory 30-day DAPT run-in phase after percutaneous coronary intervention (PCI), el...
Sep 06, 2021•4 min•Season 1Ep. 18
Results from the EMPEROR-Preserved trial were presented by Professor Stefan from Berlin in a Hot Line session on 27th August. This international double-blind trial enrolled 5,988 symptomatic HFpEF patients (LVEF >40%) with and without T2DM who had elevated N-terminal pro-BNP concentrations (>300 pg/mL in patients without and >900 pg/mL in patients with atrial fibrillation) along with evidence of structural changes in the heart or documented history of HF hospitalization. Participants w...
Sep 06, 2021•4 min•Season 1Ep. 17
This is a post hoc analysis of the ARIC study, with the objective to assess the association of diabetes duration with incident heart failure (HF). In this study, 9,734 participants from the ARIC study with mean age of 63 years without HF or coronary heart disease were included and their diabetes duration at Visit 4 was taken as baseline. After 22.5 years of follow up, it was found that, 1. Each 5-year increase in diabetes duration was associated with a 17% (95% CI: 11-22) relative increase in HF...
Jul 31, 2021•3 min•Season 1Ep. 16
This study was aimed to evaluate if a shorter course of Dual Anti-Platelet Therapy followed by P2Y12 inhibitor monotherapy is as effective as a 12-month course with fewer bleeding events. Five randomized clinical trials were included, with a total of 18,046 participants. Antiplatelet strategies compared were · aspirin and P2Y12 inhibitor for 12 months · aspirin and P2Y12 inhibitor for 1 to 3 months followed by P2Y12 inhibitor alone. In the end of the study it was found that Patients randomized t...
Jul 31, 2021•2 min•Season 1Ep. 15
Background: Patients with peripheral artery disease (PAD) undergoing Lower extremity revascularization (LER) are at high risk of major adverse limb and cardiovascular events. The VOYAGER PAD trial demonstrated that rivaroxaban 2.5 mg twice daily reduced first events by 15%. The benefit of rivaroxaban on total (first and subsequent) events in this population are unknown. The Objectives: of this study sought to evaluate the total burden of vascular events in patients with PAD after Lower extremity...
Jul 31, 2021•3 min•Season 1Ep. 14
Efficacy and Safety of Antithrombotic Strategies in Patients with Atrial Fibrillation and Recent ACS or PCI With and Without A History of Heart Failure: Insights From the AUGUSTUS Trial The Augustus trial was done in AF patients with recent ACS or PCI, and Apixaban on the background of P2Y12 without aspirin resulted in less bleeding, few hospitalization,s and no significant difference in ischemic events compared to a regimen that included a Vitamin K Antagonist, aspirin or both. Heart Failure is...
Jul 31, 2021•3 min•Season 1Ep. 13
AFFIRM-AHF-based multinational cost-effectiveness analysis of intravenous ferric carboxymaltose for the treatment of iron deficiency in an acute heart failure setting Heart Failure utilizes major resources and is an economic burden on healthcare systems. Iron deficiency is prevalent in 50% of patients with chronic HF and in 80% of patients hospitalized for acute HF. It is associated with poor functional status and increased risk of adverse outcomes in HF patients, thus Iron deficiency in HF is a...
Jul 08, 2021•4 min•Season 1Ep. 12
Vericiguat in patients with atrial fibrillation and heart failure with reduced ejection fraction: Insights from the VICTORIA (VerICiguaT global study in subjects with HFrEF) As we know, Heart failure is associated with impaired synthesis of Nitric Oxide and decreased activity of soluble Guanylate Cyclase (sGC), which may contribute to myocardial and vascular dysfunction. By directly stimulating soluble Guanylate Cyclase, independently of and synergistically with Nitric Oxide, Vericiguat augments...
Jul 08, 2021•3 min•Season 1Ep. 11
Efficacy of Omecamtiv mecabril in heart failure with reduced ejection fraction according to N-terminal pro-B-type natriuretic peptide level: Insights from the GALACTIC-HF trial. The primary outcome of this trial was the time to first heart failure event or cardiovascular death, which occurred significantly less in patients randomized to Omecamtiv mecabril group. In sub-analysis, the effect of Omecamtiv mecarbril on NT-pro BNP level, and pre-specified outcomes based on NT-pro BNP level i.e. < ...
Jul 08, 2021•3 min•Season 1Ep. 10
What is the evidence and which beta-blocker should a patient with HFmrEF receive? Till Copernicus trial ejection fraction were used to define outcome of a trial, but now this clinical parameter is used to group individuals with Heart Failure that will yield different outcome to a given treatment. In 2016, ESC Heart Failure guidelines classified and defined HF with reduced ejection fraction, HF with preserved ejection fraction, and HF with mid-range ejection fraction. Studies like CHARM, I PRESER...
Jul 08, 2021•3 min•Season 1Ep. 9
The goal of the trial was to assess the efficacy and safety of sacubitril/valsartan compared with ramipril in a contemporary acute myocardial infarction (AMI) IN THIS, 5,660 PATIENTS FROM 43 COUNTRIES WITH MEAN AGE OF 64 YEARS WITH PRIOR MI WITH Left ventricular ejection fraction ≤40% with or without pulmonary congestion WERE RANDOMIZED TO RECEIVE EITHER sacubitril/valsartan OR RAMIPRIL AND WERE FOLLOWED UP FOR 23 MONTHS. THE RESULT OF THE TRIAL SHOWED THAT, The primary outcomes of CV death or H...
May 31, 2021•2 min•Season 2Ep. 1
In this trial, 15,000 patients from 40 centers across the U.S. were self-enrolled and self-randomized between 2016 & 2019. The Participants were of median age of 67 years With 35.3% had a history of myocardial infarction (MI) and 53% had coronary revascularization within the previous five years. The Results showed after median 26 months of follow-up were as follows No significant difference in the primary effective outcome of all-cause death, MI, or stroke OR Primary safety outcome of major ...
May 31, 2021•2 min•Season 2Ep. 2
The goal of the trial was to assess the efficacy and safety of Apixaban 5 mg BID compared with standard of care (antiplatelet therapy [APT] or oral anticoagulant [OAC]) among patients undergoing transcatheter aortic valve replacement commonly known as (TAVR). In this study 1500 patients of mean age of 82 years, with 53% having a Self-expanding valve; 47% with balloon-expandable valve and 3% with valve-in-valve were included. The trial was divided into 2 layers, in one stratum Apixaban was compar...
May 31, 2021•3 min•Season 2Ep. 3
The goal of the trial was to evaluate surgical left atrial appendage occlusion compared with no occlusion among patients with atrial fibrillation undergoing open-heart surgery. In this trial, 4770 patients on anticoagulation therapy for over 3 years with atrial fibrillation with CHA2DS2-VASc ≥2, were randomized to undergo open-heart surgery with or without left atrial appendage occlusion In results: The primary outcome of ischemic stroke or systemic embolism after 3.8 years occurred in 4.8% of t...
May 31, 2021•2 min•Season 2Ep. 4
Studies have shown that patient with COVID-19 and underlying Cardiovascular disease were more likely to show raised cardiac Troponin-T and have a 70% risk of poor prognosis or early mortality, further data suggest that level of cardio biomarkers like myoglobin, NT-pro BNP was significantly higher in severe & critical cases versus mild cases. It was known that in Covid infections, cardiac morbidities like Myocarditis, Hypertensive crisis, CHF, and Myocardial infarction can cause marked elevat...
Apr 19, 2021•2 min•Season 1Ep. 4
Recently a meta-analysis was conducted on 7 randomized controlled trials of PCI or CABG plus Optimal Medical Therapy (OMT) versus OMT alone involving 10797 patients with chronic coronary syndromes This is the first meta‐analysis to include patients with CCS and severely reduced left ventricular ejection fraction as well as those with CKD. This is the only meta‐analysis with documented myocardial ischemia and in which revascularization included both PCI and CABG. After a follow-up of 5 years, it ...
Apr 19, 2021•2 min•Season 1Ep. 3
Triple combination therapy, either initial or sequential is part of the recommendation in the ESC/ERS guidelines for the treatment of Pulmonary Arterial Hypertension (PAH). OPUS is a prospective, multicenter, observational drug registry of PAH patients newly initiated on macitentan. Recently, analysis was done on treatment patterns, outcomes, and safety for PAH patients receiving triple combination therapy comprising of macitentan plus a phosphodiesterase type 5 inhibitor (PDE5i) plus a prostacy...
Apr 19, 2021•3 min•Season 1Ep. 2
Aspirin is an affordable, familiar, and most widely prescribed drug for acute and post cardiovascular events or revascularization procedures. It is also an essential member of dual antiplatelet therapy or DAPT (a P2Y12 inhibitor plus ASA) and dual pathway inhibition or DPI (Rivaroxaban plus ASA), and data for both combinations are increasing. Gastrointestinal bleeding is the most common adverse event associated with Aspirin therapy, the COGENT trial has shown that prophylactic PPI agents reduced...
Apr 19, 2021•2 min•Season 1Ep. 1
