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American College of Cardiology's 57th Annual Scientific Session, March 29-April 1, 2008

57th Annual Scientific Session of the American College of Cardiology

The 57th Annual Scientific Session of the American College of Cardiology (ACC) convened March 29-April 1 in Chicago and included nearly 30,000 health care professionals and researchers from around the world. The conference featured groundbreaking research on hypertension presented from late-breaking clinical trials, presentations on lipid treatment, advances in imaging and interventional cardiology, and in-depth coverage of relevant topics such as quality and health care reform.

According to ACC President James T. Dove, M.D., the conference's goal was to provide cardiovascular professionals with tools to ensure the highest quality of care of their patients. "The unifying influence of ACC.08 comes at an important time for our profession as we are caught in the surge of a push for health care reform amid calls for cost effectiveness and quality reporting," explained Dove.

In addition, for the first time, the conference was held jointly with the Society for Cardiovascular Angiography and Interventions (SCAI) ACCi2 Summit, a move designed to expand educational offerings for interventional cardiologists. "This conference is truly a joint conference between the two societies," said David R. Holmes Jr., M.D., co-chair of the SCAI-ACCi2, explaining the goal of "utilizing the strengths and talents of each society to put on the best scientific program of interest to interventional cardiology as well as to the general practice of cardiology disease."

The conference included presentation of data from several highly anticipated late-breaking clinical trials. In the Novartis-funded ACCOMPLISH trial, Kenneth Jamerson, M.D., of the University of Michigan in Ann Arbor, and colleagues randomized patients with inadequately controlled hypertension to receive a single pill, fixed-dose combination of benazepril and amlodipine or a pill containing benazepril and hydrochlorothiazide. While both regimens enabled the majority of patients to achieve target blood pressure goals, the benazepril/amlodipine combination was associated with a 20 percent reduction in cardiovascular events.

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These findings add to the evidence for a beneficial effect of blockade of the renin-angiotensin-aldosterone cascade, such as research recently published in the New England Journal of Medicine showing that ramipril and telmisartan reduced vascular events in high-risk patients.

Additional evidence came from the ALLAY trial, in which researchers explored the ability of the first direct renin inhibitor, aliskiren, to reduce target organ damage. Scott Solomon, M.D., of Harvard Medical School in Boston, and colleagues randomized 460 hypertensive patients with evidence of left ventricular hypertrophy to receive either daily aliskiren, losartan, or both drugs for 36 weeks to control blood pressure. Left ventricular mass, as measured by MRI, was reduced equally in the aliskiren and losartan groups. Combination therapy led to the greatest reductions, but the results failed to reach statistical significance. "Because treatment of hypertension can be difficult, physicians and patients will benefit from additional agents that can not only lower blood pressure, but can affect the end-organ damage that hypertension causes," explained Solomon.

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Amid the explosion of use in cardiac imaging come concerns about risk of radiation exposure associated with these new technologies. In the PROTECTION 1 trial, researchers analyzed data from 1,729 consecutive patients undergoing cardiac CT angiography to investigate the use and efficacy of radiation dose-saving algorithms. The researchers reported that radiation dose estimates differed widely among the 50 study sites, and use of dose-saving algorithms resulted in 25 to 69 percent reductions in dose estimates.

"Although cardiac CT is a very promising technology, educational efforts and further technical developments are needed to keep the radiation exposure as low as reasonably achievable," said Jorg Hausleiter, M.D., of the German Heart Center at the Technical University in Munich, Germany, and lead author of the study.

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Another study explored the link between psychological health and heart disease, revealing that patients with coronary artery disease whose anxiety level decreased or stayed constant were 60 percent less likely to have a heart attack or die compared to patients whose anxiety level increased over the study period.

"These findings should reinforce to cardiologists a need to attend to the whole patient by paying attention to psychological problems in addition to cardiovascular disease," said lead study author Yinong Young-Xu, Ph.D., of the Lown Cardiovascular Research Foundation in Brookline, Mass. "If we can lower heart patients' anxiety level, we may be able to reduce their risk of heart attack and prolong their life."

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ACC: Treatment Fails in High-Risk Heart Surgery Patients

TUESDAY, April 1 (HealthDay News) -- Pyridoxal 5'-phosphate (MC-1) given before coronary artery bypass graft surgery and daily for the next month didn't reduce cardiovascular death or non-fatal myocardial infarction in patients, according to research published online April 1 in the Journal of the American Medical Association and presented this week at the American College of Cardiology's 57th Annual Scientific Session in Chicago.

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ACC: Avandia Appears Safe in Diabetics with Heart Disease

TUESDAY, April 1 (HealthDay News) -- The diabetes drug rosiglitazone (Avandia), which has come under fire in recent months due to concerns about increased risks of cardiovascular events, appears to be safe for use in high-risk diabetics, according to research presented this week at the American College of Cardiology's 57th Annual Scientific Session in Chicago.

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ACC: Rimonabant Fails to Reduce Atherosclerosis in Trial

TUESDAY, April 1 (HealthDay News) -- Although rimonabant was associated with more weight loss and other beneficial factors in subjects with abdominal obesity and coronary artery disease, it didn't show an effect on percent atheroma volume, according to trial results published online April 1 in the Journal of the American Medical Association and presented this week at the American College of Cardiology's 57th Annual Scientific Session in Chicago.

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ACC: 'Normal Weight Obesity' Common, Tied to Heart Risks

TUESDAY, April 1 (HealthDay News) -- More than half of Americans with normal body weight have excessive body fat, a condition termed "normal weight obesity," and may be at risk for developing heart problems and diabetes, according to research presented at the American College of Cardiology's 57th Annual Scientific Session this week in Chicago.

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ACC: Home Automated External Defibrillators Ineffective

TUESDAY, April 1 (HealthDay News) -- In patients who survive an anterior-wall myocardial infarction and are deemed too healthy to receive an implantable cardioverter-defibrillator, access to a home automated external defibrillator does not improve overall survival compared to conventional resuscitation methods, according to the results of a study published in the April 1 issue of the New England Journal of Medicine and presented at the American College of Cardiology's 57th Annual Scientific Session held this week in Chicago.

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ACC: Statin Regimen Leads to Atherosclerosis Regression

MONDAY, March 31 (HealthDay News) -- High-dose treatment with rosuvastatin not only improves lipid profiles but also leads to regression of atherosclerotic plaques in narrowed coronary arteries, according to research published online March 31 in Circulation: Journal of the American Heart Association and presented at the American College of Cardiology's 57th Annual Scientific Session this week in Chicago.

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ACC: Drug May Slow Atherosclerosis in Diabetics

MONDAY, March 31 (HealthDay News) -- Among patients with type 2 diabetes and coronary artery disease, treatment with pioglitazone may slow progression of coronary atherosclerosis, according to research published online March 31 in the Journal of the American Medical Association and presented at the American College of Cardiology's 57th Annual Scientific Session held this week in Chicago.

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ACC: Telmisartan, Ramipril Comparable for Vascular Events

MONDAY, March 31 (HealthDay News) -- A randomized trial comparing ramipril to telmisartan in high-risk patients concluded that the two are equivalent in reducing vascular events and death from cardiovascular causes, according to research published online March 31 in the New England Journal of Medicine and presented at the American College of Cardiology's 57th Annual Scientific Session held this week in Chicago.

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ACC: Treatment of Hypertension Is Beneficial in Elderly

MONDAY, March 31 (HealthDay News) -- Treatment of hypertension in individuals aged 80 and older appears to be beneficial, significantly reducing the risk of stroke and death from any cause, according to an article published online March 31 in the New England Journal of Medicine and presented at the American College of Cardiology's 57th Annual Scientific Session held this week in Chicago.

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SCAI-ACC: Left Main Coronary Disease Treatments Compared

MONDAY, March 31 (HealthDay News) -- In patients with left main coronary artery disease, percutaneous coronary intervention (PCI) with stenting and coronary artery bypass grafting (CABG) result in similar rates of death, though the rate of target-vessel revascularization is higher in patients treated with stenting, according to an article published online March 31 in the New England Journal of Medicine and presented at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit (SCAI-ACCi2) in Chicago.

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SCAI-ACC: Prasugrel Beneficial for Coronary Syndromes

MONDAY, March 31 (HealthDay News) -- Intensive antiplatelet treatment with prasugrel is superior to clopidogrel in improving outcomes and reducing stent thrombosis in patients with acute coronary syndromes who have coronary stents, according to the results of a study published online March 31 in The Lancet and presented at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit in Chicago this week.

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ACC: Drugs Effective in ST-Segment Elevation Heart Attack

MONDAY, March 31 (HealthDay News) -- In patients undergoing percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI), tirofiban and abciximab treatment are similarly effective at resolving ST-segment elevation, while sirolimus-eluting stents are superior to uncoated stents in reducing major cardiac events, according to a report published online March 30 in the Journal of the American Medical Association and presented at the American College of Cardiology's 57th Annual Scientific Session this week in Chicago.

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SCAI-ACC: In Angioplasty, Bivalirudin Bests Heparin Combo

MONDAY, March 31 (HealthDay News) -- The direct thrombin inhibitor bivalirudin (Angiomax) leads to reduced rates of major bleeding and decreased cardiovascular mortality in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention compared to standard treatment with heparin plus glycoprotein IIb/IIIa inhibitors. These research findings were presented at the SCAI Annual Scientific Sessions in Partnership with the ACC i2 Summit (SCAI-ACCi2), held this week in Chicago.

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ACC: No Benefit Seen with Zetia's Extra Lipid-Lowering

MONDAY, March 31 (HealthDay News) -- A study showing that combination treatment with ezetimibe (Zetia) and a statin does not reduce progression of atherosclerotic disease compared to a statin alone, and an article comparing ezetimibe prescribing patterns in the United States and Canada are among the research findings published online March 30 in the New England Journal of Medicine. These results and implications were discussed this week at the American College of Cardiology's 57th Annual Scientific Session in Chicago.

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