American Heart Association, Nov. 13-17, 2010

The American Heart Association's Scientific Sessions 2010

The American Heart Association's Scientific Sessions 2010 took place Nov. 13 to 17 in Chicago and attracted approximately 25,000 participants from around the world. The conference highlighted advances in the prevention, diagnosis, and management of hypertension, high cholesterol, diabetes, myocardial infarction, congestive heart failure, arrhythmias, and stroke.

In the ADVANCE (Evaluation of the HeartWare HVAD Left Ventricular Assist Device System for the Treatment of Advanced Heart Failure) trial, Keith D. Aaronson, M.D., of the University of Michigan Medical Center in Ann Arbor, and colleagues found that an experimental centrifugal flow pump, HVAD, showed similar survival rates as commercially available left ventricular assist devices. The investigators compared the outcomes of 140 patients who received the HVAD to 499 patients who received commercially available left ventricular assist devices as a bridge to transplant (BTT).

The investigators found that 92 percent of patients who received the HVAD survived for 180 days with the pump, received a transplant, or had recovered enough to have the device removed. The investigators also found that 90 percent of control patients waiting for heart transplants on approved pumps, including the HeartMate II, were treated successfully.

"When we compared HVAD outcomes with those in the literature, we found that bleeding rates, infection rates, and ventricular arrhythmias were substantially lower than had been reported for the HeartMate II when it was studied as a BTT. The rate of stroke was similar to that found with the HeartMate II," Aaronson said. "Infection rates were also lower than reported previously for the HeartMate II in its BTT trial. The sepsis rate was two-thirds lower, and drive line infections decreased by one-third with the HVAD, with the rate of non-device local infection also improving with the HVAD."

Aaronson suggested that the improvement in non-device local infections may be attributable to a less invasive procedure as well as less bleeding associated with the procedure.

"While it's reasonable for doctors to look at the best available trial data and make informed comparisons across trials, only head-to-head trials like this can provide definitive comparisons of outcomes on different devices," Aaronson added.

The study was funded by HeartWare Inc.; several authors disclosed financial relationships with HeartWare, Thoratec, and other medical device companies.

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In a retrospective review of data from the prospective multicenter HeartMate II BTT and destination therapy (DT) trials, Daniel J. Goldstein, M.D., of the Montefiore Medical Center in Bronx, N.Y., and colleagues found that left ventricular recovery occurred in nearly 2 percent of patients undergoing treatment with the HeartMate II. The review assessed 490 BTT, 600 DT, and 18 compassionate use patients.

Among the 20 patients who experienced left ventricular recovery, the investigators found that these patients were more likely to have non-ischemic cardiomyopathy, be younger than 45 years of age, and have had diagnosed heart failure for less than one year. The investigators concluded that rigorous testing for left ventricular recovery should be completed in this subset of patients.

Several authors disclosed financial relationships with Thoratec and other medical device companies.

Abstract No. 18067

In another study, Michelle A. Albert, M.D., of Brigham and Women's Hospital in Boston, and colleagues found that women with high job strain had an increased risk of cardiovascular disease and those with job insecurity were at a higher risk of high blood pressure, high cholesterol, and being overweight. The investigators evaluated the impact of job strain and job insecurity on incident cardiovascular disease among 17,415 healthy women health professionals participating in the Women's Health Study over 10 years of follow-up.

"We categorized women into four stress categories, including low (reference group), passive (low demand and low control), active (high demand and high control), and high (high demand and low control) based on the widely used Karasek job strain model," Albert said.

The investigators found that women with high job strain had a 40 percent increased risk of experiencing a cardiovascular event compared to those with low job strain.

"Job strain among women is significantly associated with cardiovascular events, with a two-fold increase in the rate of myocardial infarction," Albert added. "At this time, we recommend that women with high job strain enhance physical activity, develop good coping mechanisms, engage in active social support, and limit intrusion of work life into social life. In addition, practicing clinicians should question patients about stress levels when evaluating their overall health."

Abstract No. 18520

As part of the DEFINE (Determining the Efficacy and Tolerability of CETP Inhibition with Anacetrapib) study, Christopher P. Cannon, M.D., of Brigham and Women's Hospital in Boston, and colleagues found that a cholesteryl ester transfer protein inhibitor, anacetrapib, effectively raised high-density lipoprotein (HDL) cholesterol and reduced low-density lipoprotein (LDL) cholesterol, with limited adverse events. The investigators randomized 1,623 patients who were undergoing treatment with a statin to receive 100 mg of anacetrapib or placebo daily for 18 months.

"We saw an increase in HDL that far surpassed anything seen before. In patients who were already treated with statins and reached an LDL goal of 81, we administered the investigational drug and found that HDL increased by 138 percent, more than five to 10 times than we've been able to do previously," Cannon said. "In addition, the drug reduced LDL levels by 40 percent; they went from 81 on average down to 45. The risk ratio decreased significantly."

This research was also published online Nov. 17 in the New England Journal of Medicine to coincide with the conference.

The study was funded by Merck Research Laboratories; several authors disclosed financial relationships with Merck and other pharmaceutical companies.

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AHA: Statins Not Associated With Increased Cancer Risk

WEDNESDAY, Nov. 17 (HealthDay News) -- Patients undergoing treatment with statins do not appear to be at an increased risk of cancer due to their statin use, according to research presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: Renal Denervation Works in Resistant Hypertension

WEDNESDAY, Nov. 17 (HealthDay News) -- Renal denervation using a catheter-based approach appears to substantially reduce blood pressure, without major adverse events, in patients with treatment-resistant hypertension, according to a study published online Nov. 17 in The Lancet to coincide with presentation at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: Phone Intervention May Improve BP Control

WEDNESDAY, Nov. 17 (HealthDay News) -- A telephone-based behavioral intervention appears effective in improving hypertension control, according to a study presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago. According to another study published online Nov. 16 in the New England Journal of Medicine to coincide with presentation at the conference, telemonitoring does not improve outcomes in individuals recently hospitalized for heart failure.

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AHA: Less Sleep in Men Tied to Heart Disease Risk Factor

TUESDAY, Nov. 16 (HealthDay News) -- Shorter sleep duration appears to be associated with greater carotid intima-media thickness (IMT) in men but not in women, according to a study presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

Abstract No. 16034
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AHA: Supplement Use High in Warfarin-Treated Patients

TUESDAY, Nov. 16 (HealthDay News) -- Patients treated with warfarin often use herbal and dietary supplements (HDS) without their physician's knowledge and may be at an increased risk for bleeding or thromboembolic events, according to a study presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: Drug-Eluting Stents Not Tied to Increased Risks

TUESDAY, Nov. 16 (HealthDay News) -- Patients with coronary disease in the large arteries who receive sirolimus-eluting or everolimus-eluting stents are not at an increased risk of death or myocardial infarction compared to those who receive bare-metal stents, with similar reductions in the rates of target-vessel revascularization associated with the two drug-eluting stents, according to a study published online Nov. 16 in the New England Journal of Medicine to coincide with presentation at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: Revascularization May Be Best for CAD Plus Diabetes

TUESDAY, Nov. 16 (HealthDay News) -- Patients with coronary artery disease and diabetes who undergo revascularization appear to demonstrate improved blood flow compared to those who undergo aggressive medical management alone, according to a study presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

Abstract No. 12697
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AHA: Single Epoetin Alfa Infusion May Not Help in STEMI

TUESDAY, Nov. 16 (HealthDay News) -- A single infusion of epoetin alfa in patients with ST-segment elevation myocardial infarction (STEMI) who undergo successful percutaneous coronary intervention (PCI) appears to provide more harm than benefit, according to a study presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: ICD-CRT Linked to Less Death, Hospitalization

MONDAY, Nov. 15 (HealthDay News) -- In a certain group of heart failure patients, adding cardiac-resynchronization therapy (CRT) to an implantable cardioverter-defibrillator (ICD) appears to reduce rates of death and hospitalization for heart failure but raises the risk of adverse events, according to a study published online Nov. 14 in the New England Journal of Medicine to coincide with presentation at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: Recurrent A-Fib Not Improved With Omega-3's

MONDAY, Nov. 15 (HealthDay News) -- Prescription omega-3 fatty acid supplements do not appear to reduce recurrent atrial fibrillation (AF) over a six-month period, according to a study published online Nov. 15 in the Journal of the American Medical Association to coincide with presentation at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: External Defibrillators Don't Offer In-Hospital Benefit

MONDAY, Nov. 15 (HealthDay News) -- The use of automated external defibrillators (AEDs) in patients with in-hospital cardiac arrest does not appear to improve survival, according to a study published online Nov. 15 in the Journal of the American Medical Association to coincide with presentation at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: Vitamin D Deficiency's Role in Cardiac Events Studied

MONDAY, Nov. 15 (HealthDay News) -- Vitamin D deficiency is associated with a variety of adverse cardiovascular outcomes, and these associations were evaluated in several studies presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: In Cardiac Arrest, Ending Care Too Early May Be Deadly

MONDAY, Nov. 15 (HealthDay News) -- Withdrawing care after 72 hours from patients who survive cardiac arrest may end lives prematurely, according to research presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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AHA: Smoking Over 15 Years Ago Tied to Heart Failure Risk

MONDAY, Nov. 15 (HealthDay News) -- Individuals with more than 30 pack-years of smoking history who quit smoking over 15 years ago remain at an increased risk for heart failure, and the prevalence of current smoking appears to have dramatically declined among adults, according to two studies presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

Abstract No. 17788
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AHA: Moderate Alcohol Intake Tied to Good Health Outcomes

MONDAY, Nov. 15 (HealthDay News) -- Moderate intake of alcohol is associated with a reduced rate of adverse cardiovascular events after coronary artery bypass grafting (CABG), especially in men; a decreased risk of total stroke in women; and a modest increase in overall health status among women who survive to older ages, according to three studies presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

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