First and foremost our prayers are with the victims and people of central Italy where an Earthquake struck last week, only 100 miles from Rome where the European Society of Cardiology convened this week for its congress.
The meeting commenced today and there were two clinical trials worthy of mention: ANTARCTIC and DANISH studies.
The Antarctic Study
The ANTARCTIC study set out to determine if elderly patients with a recent acute coronary syndrome (i.e. angina or heart attack) had their anti-platelet therapy tailored by using a platelet assay (test) could affect outcomes for patients. The drugs that were evaluated were prasugrel (Effient) and clopidogrel. All patients underwent stenting.
“Among elderly patients with acute coronary syndrome undergoing stenting, tailored antiplatelet therapy did not improve outcomes compared with conventional antiplatelet therapy. Tailored antiplatelet therapy resulted in a large proportion of patients that were down-titrated to clopidogrel therapy. The results of this trial complement the ARCTIC trial, which also failed to demonstrate benefit for tailored antiplatelet therapy.”-Deepak Bhatt MD.
Despite the intutive promise of attempting to tailor therapy for patients using simple non-genetic assays, currently there does not appear to be any benefit.
The Danish Study
The DANISH study looked to determine whether the use of a defibrillator was of benefit in patients with systolic dysfunction (LVEF <35%) compared to usual care for patients who had non-ischemic cardiomyopathy.
“Among patients with a nonischemic cardiomyopathy, ICD implantation did not reduce long-term mortality compared with usual care; however, there was suggestion of benefit among younger patients. Although there was lack of benefit for the primary outcome, ICD was associated with a reduction in sudden cardiac death versus usual care. Device infections were similar between the groups.”-Deepak Bhatt MD.
“Prophylactic ICD implantation is a class 1 recommendation in patients with heart failure and reduced left ventricular systolic function in both European and American guidelines,” he explained. “However, the evidence is much weaker for patients with non-ischemic aetiology. Until now, there has been the limited data on ICDs in this population, and our trial fills that gap by suggesting ICDs should not be routinely implanted in all patients with systolic heart failure.”- Lars Kober (study investigator).
There is much more news and late breaking clinical trial data to come in the ensuing days at the ECS 2016 meeting. For further information please visit http://www.escardio.org/Congresses-&-Events/ESC-Congress/ESC-Congress.