May 17, 2021
Use of apixaban (Eliquis; Bristol-Myers Squibb) following transcatheter aortic valve implantation does not significantly reduce the risk of subclinical valve thrombosis when compared with standard of care, according to a CT substudy from the ATLANTIS trial presented today.
However, the results are nuanced, with investigators reporting an intriguing interaction between thrombus risk and prior oral anticoagulation indication. For patients without an indication for oral anticoagulation, use of apixaban as opposed to antiplatelet therapy was associated with a lower risk of subclinical valve thrombosis as measured by reduced leaflet motion (RLM) and hypoattenuated leaflet thickening (HALT).
By contrast, for those with an indication for oral anticoagulation, apixaban failed to prevent subclinical valve thrombosis when compared with a vitamin K antagonist.
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A novel approach to heart failure with preserved ejection fraction (HFpEF) that takes a page from fibrotic lung disease appeared to pay off, with a reduction in myocardial fibrosis, the phase II PIROUETTE trial showed.
The antifibrotic drug pirfenidone (Esbriet, approved for idiopathic pulmonary fibrosis) reduced myocardial extracellular volume by 1.21 percentage points more than placebo over 52 weeks (0.7% decline vs 0.5% increase,
P=0.009).
A treatment effect of that magnitude would be expected to translate to a 9% to 28% reduction in heart failure hospitalization or death, based on recent observational studies, reported Christopher Miller, MBChB, PhD, of the University of Manchester in England, at the virtual American College of Cardiology (ACC) meeting.
The American College of Cardiology s (ACC) Global Heart Attack Treatment Initiative (GHATI) had measurable positive impacts on care delivery for heart attacks in low- and middle-income countries, according to data from the program s first year. Results were presented at the ACC s 70th Annual Scientific Session.
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Dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, did not significantly reduce the risk of organ failure or death or improve recovery in patients hospitalized with COVID-19 who are at high risk of developing serious complications compared to placebo, according to data presented at the American College of Cardiology s 70th Annual Scientific Session. The researchers, while acknowledging the results were not statistically significant, said they were encouraged by the lower numbers of organ failure and deaths observed in patients treated with dapagliflozin and by favorable safety data.
COVID-19 can lead to multi-organ failure, especially in patients at high risk for severe illness and complications. The Dapagliflozin in Respiratory Failure in Patients with COVID-19 (DARE-19) trial was the first phase III randomized, controlled clinical trial that was initiated to determine whether dapagliflozin could reduce cardiovascular, kidney and respiratory complications