Analyses of landmark, practice-changing trials will pepper the three late-breaking science sessions.
Late-Breaking Science 2
The Late-Breaking Science 2 session will focus on prevention and will include analyses from the two most illuminating and perhaps practice-changing trials presented this year, FOURIER and CANTOS. REVEAL, another large and important trial of 2017, also spawned a subanalysis in this deep-diving session at 9:00 a.m.-10:15 a.m.:
- REAL-CAD: This study evaluated the prevention of cardiovascular disease with pitavastatin 1 mg/day or 4 mg/day in patients with stable coronary artery disease followed for 3-6 years. In the REAL-CAD (Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy With Pitavastatin in Coronary Artery Disease) trial, presented by Takeshi Kimura, MD, of Kyoto (Japan) University, the primary endpoint was the occurrence of cardiovascular death, nonfatal MI, nonfatal cerebral infarction, or unstable angina.
- REVEAL: Presented in August at the European Society of Cardiology Congress (ESC), the primary results of REVEAL (Randomized Evaluation of the Effects of Anacetrapib Through Lipid-Modification), a multicenter, pivotal trial with more than 30,000 patients treated for about 4 years, showed that patients treated with anacetrapib had a statistically significant 9% decrease in major coronary events, compared with placebo-treated controls. The analysis to be presented at AHA by Martin Landrey, MD of the University of Oxford, England, examined the effects of anacetrapib on the incidence of new-onset diabetes and on vascular events in people with diabetes.
- FOURIER: This blockbuster trial in more than 27,000 patients showed that the PCSK9 inhibitor evolocumab significantly improved cardiovascular outcomes in high-risk patients already on statin therapy and has already started spawning important subanalyses. Two will be presented in this session. First, Marc P. Bonaca, MD, of Brigham & Women’s Hospital in Boston, will present outcomes in patients with peripheral artery disease. Second, Marc S. Sabatine, MD, also of Brigham & Women’s, will present the clinical benefit of evolocumab in patients with a history of MI.
- CANTOS: The findings of CANTOS (Canakinumab Anti-Inflammatory Thrombosis Outcome Study) stunned the cardiovascular world and piqued interest in their oncology colleagues. “These data provide the first proof that inflammation inhibition in the absence of lipid lowering can improve atherogenic outcomes and potentially alter progression of some fatal cancers,” declared Paul M. Ridker, MD, of Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, both in Boston, at ESC. In CANTOS, the fully human monoclonal antibody canakinumab, which targets IL-1B, reduced the risk of recurrent cardiovascular events by 15% in a very-high-risk population, compared with placebo, while cutting incident lung cancer by 67%.
Late-Breaking Science 3
This session promises insights into hypertension management and will be held at 10:45 a.m.-12:00 p.m.:
- Chinese BP trial: Presented by Mar Pujades-Rodriguez, PhD, of the University of Leeds, (England), this study examined time at blood pressure target and the risk of cardiovascular diseases and mortality in a Chinese population.
- SPRINT: Yes, the trial that upended hypertension guidelines is bearing fruit again. This analysis of SPRINT (Systolic Blood Pressure Intervention Trial) looked at blood pressure measurement. Karen C. Johnson, MD, of the University of Tennessee, Memphis, will present the results.
- GATEWAY: As the benefits of bariatric surgery seem to pile up, the GATEWAY (Gastric Bypass to Treat Obese Patients With Steady Hypertension) trial focused on reducing the need for antihypertensive drugs and decreasing systemic arterial blood pressure and other risk factors for cardiovascular events in patients with arterial hypertension randomized to Roux-en-Y gastroplasty or to clinical treatments. Carlos A. Schiavon, MD, of Heart Hospital in São Paulo will present the results.
Late-Breaking Science 4
Billed as covering the “sweet spot in cardiometabolic care,” this session will highlight new findings from three of the biggest trials in type 2 diabetes management. The session will run at 3:45 p.m.-5:00 p.m.
- CANVAS: Presented at ESC, the results of this large, FDA-mandated cardiovascular outcomes trial showed that canagliflozin significantly reduced the risk of cardiovascular and renal events but doubled the risk of amputation, compared with placebo, in patients with type 2 diabetes. In this subanalysis of CANVAS (the Canagliflozin Cardiovascular Assessment Study), presenter Kenneth W. Mahaffey, MD, of Stanford (Calif.) University, and his coinvestigators looked at primary and secondary prevention of cardiovascular events in the same population.
- EXSCEL: The results of this trial, also presented at ESC, showed that exenatide was noninferior to placebo with respect to cardiovascular safety but not superior with respect to efficacy. Presenter Robert J. Mentz, MD, of Duke University, Durham, N.C., will present more news from the EXSCEL (Exenatide Study of Cardiovascular Event Lowering) trial.
- EMPA-REG OUTCOME: The first trial to show a cardioprotective effect of an SGLT-2 inhibitor in type 2 diabetes patients, EMPA-REG OUTCOME, marked a new era in diabetes treatment. Bernard Zinman, MD, of the University of Toronto, will present an subset analysis of patients with type 2 diabetes and peripheral artery disease. The session title signals more good news: Empagliflozin Reduces Mortality and Hospitalization for Heart Failure in Patients With Type 2 Diabetes and Peripheral Artery Disease.
On Twitter @cardionews