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Late-Breaking Science preview: Tuesday, Nov. 14


 

 

On the third day of the American Heart Association scientific sessions, antithrombotic therapy is the focus of the Late-Breaking Science 5 presentation, at 10:45 a.m.-12 p.m. on Tuesday, Nov. 14, followed by innovative investigations in evaluating quality improvement and patient-centered care interventions in the Late-Breaking Science 6 session, to be held at 3:45-5:15 p.m. Here are some highlights.

Late-Breaking Science 5, antithrombotic therapy

Dr. Andre Lamy of the Population Health Research Institute, Hamilton, Ont.
Dr. Andre Lamy
The session begins with a cost analysis of the COMPASS (Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease) trial, which randomized more than 27,000 patients with stable coronary artery disease to antithrombotic treatment with either rivaroxaban plus aspirin or aspirin alone. The main results, presented in August, showed that the dual regimen reduced the combined rate of cardiovascular disease events by 24%, compared with aspirin alone. Andre Lamy, MD, of the Population Health Research Institute, Hamilton, Ont., will present the cost analysis:

  • RE-DUAL PCI: Jonas Oldgren, MD, of Uppsala (Sweden) University, will present an unspecified subgroup analysis from the RE-DUAL PCI (Dual Antithrombotic Therapy With Dabigatran in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention) trial, focusing on one arm of the study. The main results, presented in August, showed patients with atrial fibrillation who had undergone percutaneous coronary intervention had a lower risk of bleeding if they received dual therapy with dabigatran plus clopidogrel or ticagrelor than did those treated with warfarin, clopidogrel, or ticagrelor.
  • POISE-2 PCI: Michelle M. Graham, MD, of the University of Alberta, Edmonton, will present a substudy of POISE-2 focusing on the patients in undergoing noncardiac surgery who had a previous percutaneous coronary intervention. POISE-2, published in 2014, showed that administering aspirin periprocedurally had no effect on the rate of a composite of death or nonfatal MI, but increased the risk of major bleeding.
    Dr. Jonas Oldgren
  • GEMINI-ACS-1: In the main study, the risk of major bleeding was similar between ACS patients treated with a combination of low-dose rivaroxaban and a P2Y12 inhibitor and those treated with aspirin and P2Y12 inhibitor. Matthew T. Roe, MD, Duke Clinical Research Institute, Durham, N.C., will present the substudy focusing on P2Y12 inhibitor switching in response to routine notification of CYP2C19 clopidogrel metabolizer status following ACS.
  • PRAGUE-18: Zuzana Motovska, MD, of Charles University in Prague, will present an unspecified substudy of PRAGUE-18, which in August 2016 showed no difference in safety or efficacy between prasugrel and ticagrelor in AMI patients undergoing primary angioplasty.

Late-Breaking Session 6, quality improvement and patient-centered care

The seven presentations in this session range from findings from the enormous SWEDEHEART registry on how treatments have improved for ST-elevation MI over 20 years, to STIC2IT, a cluster randomized, controlled trial to test whether a novel telepharmacist-based intervention for patients with metabolic syndrome improves medication adherence and disease control.

Dr. Matthew T. Roe of the Duke Clinical Research Institute, Durham, N.C
Dr. Matthew T. Roe

Other presentations include evaluation of a quality improvement toolkit on AMI in India called ACS QUIK; a trial of a decision support intervention for patients and caregivers offered a heart assist device as destination therapy called DECIDE-LVAD; a national rollout of a clinical guidance framework for the assessment of patients with possible ACS in emergency departments (iCARE-ACS); and a report from the American College of Cardiology’s Mission: Lifeline STEMI ACCELERATOR-2 study.

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