Lo Mejor del Congreso Europeo de Cardiología 2013 Amsterdam

Congreso Europeo de Cardiología 2013. Te presentamos una selección de los contenidos más relevantes del Congreso ESC 2013 en Amsterdam que no te puedes perder, será como si hubieras estado allí.

Congreso ESC 2013

Nuevas Guías de la Sociedad Europea de Cardiología

Guías 2013 Sociedad Europea de Cardiología Hipertensión Arterial »
Guías 2013 Sociedad Europea de Cardiología Marcapasos / Resincronización Cardiaca »
Guías 2013 Sociedad Europea de Cardiología Diabetes, Pre-Diabetes y Enfermedades Cardiovasculares »
Guías 2013 Sociedad Europea de Cardiología Angina de Pecho Estable »

Estudios Destacados

  • RELAX-AHF: Administration of serelaxin to patients with acute heart failure: are there any differences across RELAX- AHF subgoups?
    Resultados: The effects of serelaxin versus placebo were homogenous across multiple subgroups with respect to the primary dyspnoea relief endpoints, 60-day composite outcomes, and 180-day mortality. Larger benefits were seen in elderly patients, patients with no previous HF hospitalization, atrial fibrillation, and not previously treated with antagonists of the renin-angiotensin-aldosterone system, and those with inflammation. However, the present study is underpowered for the subgroup analyses and many analyses were performed. Thus, these results must be considered as hypothesis-generating.
    Comentario del Investigador Principal y Discusión » | Artículo en Eur Heart J »
  • Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12 440 patients of the ESC Heart Failure Long-Term Registry
    Resultados: In patients hospitalised with acute HF, use of intravenous inotropes and nitrates was not in line with the guideline recommendations. Prescription rates of all recommended oral medications significantly increased at discharge compared to preadmission. Professor Maggioni said: “Treatment recommendations for patients hospitalised with acute AF are largely based on expert opinion, which may explain why adherence is low. But hospitalisation does provide an opportunity to improve prescription of oral medications”.
    Noticia » | Artículo en Eur J Heart Failure »
  • Safety and Efficacy of Drug-Eluting Stents in Women: An Individual Patient-Level Pooled Analysis of 26 Randomized Trials Including 11,557 Women
    Resultados: Women comprise less than 30% of patients recruited in randomized trials examining the role of DES in patients with CAD. This largest patient-based pooled analysis shows that the use of DES in women is safe and effective as compared to BMS during long-term follow-up. Among women, newer-generation DES use was associated with improved safety outcomes as compared to early-generation DES.
    Comentario del Investigador Principal y Discusión » | Artículo en The Lancet »
  • Estudio ORIGIN: Association between Hypoglycemia and Risk of Cardiovascular Events with Titrated Insulin Glargine or Standard Care
    Resultados: Severe, but not non-severe, hypoglycemia increases the risk for CV outcomes in people at high CV risk and dysglycemia. This risk did not relate to insulin glargine-mediated normoglycemia, but was apparent in the presence of standard glucose lowering therapy. Nocturnal hypoglycemia did not predict arrhythmic or CV death.
    Comentario del Investigador Principal y Discusión » | Artículo en Eur Heart J »
  • Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial
    Resultados: This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard hospitalization for heart failure therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of hospitalization for heart failure patients without diabetes mellitus.
    Artículo en Eur Heart J »
  • Estudio PARTNER: Transcatheter versus Surgical Aortic Valve Replacement in Patients with Diabetes and Severe Aortic Stenosis at High Risk for Surgery
    Resultados: Among patients with diabetes and severe AS who are at high-risk for surgery, this post-hoc stratified analysis of the PARTNER trial suggests that there appears to be a survival benefit, no increase in stroke, and less renal failure from treatment with TAVR compared to SAVR.
    Comentario del Investigador Principal y Discusión »
  • Estudio IABP-SHOCK II: Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock
    Resultados: The 12-month follow-up data support that IABP did not significantly reduce mortality in patients with cardiogenic shock complicating acute myocardial infarction with an early revascularization strategy. For cardiogenic shock survivors the quality-of-life is good.
    Comentario del Investigador Principal y Discusión »
  • Estudio CHAMPION: Cangrelor for Percutaneous Coronary Intervention
    Resultados: . Compared with clopidogrel, cangrelor may be useful as an adjunct to aspirin and anticoagulation for patients undergoing PCI in order to decrease periprocedural thrombotic complications, albeit at the expense of increased non-fatal bleeding.
    Comentario del Investigador Principal y Discusión »
  • Estudio AMADEUS: Development of a novel composite stroke and bleeding risk score in patients with atrial fibrillation
    Resultados: We have developed and validated a novel composite score for stroke/thromboembolism/bleeding. Whilst individual risk stratification with existing stroke and bleeding scores would allow personalized balancing of the risk of stroke/thromboembolism against serious bleeding, the value of this composite score merits further study.
    Comentario del Investigador Principal y Discusión »
  • Estudio High-STEACS: High-sensitivity cardiac troponin and the under diagnosis of myocardial infarction in women
    Resultados: In comparison to men, women with suspected acute coronary syndrome are more likely to be misdiagnosed and under treated for myocardial infarction. Whilst having little effect in men, a high-sensitivity troponin assay doubles the diagnosis of myocardial infarction in women. Whether implementation of high-sensitivity assays will improve clinical outcomes and address persisting discrepancies in the management of women with suspected acute coronary syndrome requires urgent attention.
    Comentario del Investigador Principal y Discusión »
  • Estudio REGARDS: Optimal blood pressure levels in elderly persons in the reasons for geographic and racial differences in stroke (REGARDS) cohort study
    Resultados: The results suggest that for all patients above 55 the recommended level of SBP should be <140 mmHg, including the oldest patients (>75 years old), with the most reasonable values between 120-139 mmHg. The intensive hypertension therapy (with targeted BP<120 mmHg) should be a matter of further investigations.
    Comentario del Investigador Principal y Discusión »
  • Estudio PURE-Sodium: Heterogeneity in the associations of urinary sodium and potassium with blood pressure
    Resultados: Dietary Na reduction and K increase likely reduce BP to a greater extent in those with high Na consumption, hypertension and elderly and have substantially lesser effects in those with moderate or low levels of Na consumption, younger individuals and non hypertensive individuals. Our findings have implications for international guidelines and public health strategies.
    Comentario del Investigador Principal y Discusión »

Hot Line I: Late Breaking Trials on Thrombosis

Hot Line II: Late Breaking Trials on Intervention and Devices

  • Estudio PRAMI: Preventive PCI Results in Better Outcomes than Culprit Artery PCI Alone in ST Elevation MI
    Resultados: Heart attack patients with ST elevation who undergo a preventive procedure to unblock additional coronary arteries have significantly better outcomes than those whose treatment is confined to the culprit blockage only.
    Noticia » | Diapositivas » | Artículo en NEJM »
  • Estudio ACCOAST: A Comparison of Prasugrel at the Time of Percutaneous Coronary Intervention or as Pre-treatment At the Time of Diagnosis in Patients with Non-ST-Elevation Myocardial Infarction
    Resultados: In patients with non-ST-elevation acute coronary syndrome (NSTE- ACS), pre-treatment with the P2Y12 antagonist prasugrel prior to catheterization, significantly increases the risk of life-threatening bleeding without reducing the risk of major ischemic events.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas » | Artículo en NEJM »
  • Estudio DECAAF: Delayed Enhancement - MRI determinant of successful Catheter Ablation of Atrial Fibrillation (DECAAF): Analysis of post ablation scar and outcome
    Resultados: In patients with atrial fibrillation, delayed enhancement magnetic resonance imaging (DE-MRI) performed before ablative treatment can stage the degree of damaged heart tissue (atrial fibrosis) and help predict whether treatment will be successful or not.
    Noticia » | Diapositivas »
  • Estudio PRAGUE 14: Perioperative ischemia versus perioperative bleeding in consecutive cardiac patients undergoing non-cardiac surgery
    Resultados: A shortened pre-surgical interruption of anti-thrombotic therapy, compared to the more traditional one-week interruption, has no influence on perioperative complications in cardiac patients.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas »
  • Estudio LINC: A multicenter randomized trial comparing a mechanical CPR algorithm using LUCAS vs. manual CPR in out-of-hospital cardiac arrest patients
    Resultados: Mechanical chest compressions with defibrillation during ongoing compressions are just as effective, but not superior to manual compressions, for delivering cardiopulmonary resuscitation (CPR) to patients in cardiac arrest.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas »
  • Estudio IN-TIME: The Influence of Implant-Based Home Monitoring on the Clinical Management of Heart Failure Patients with an Impaired Left Ventricular Function
    Resultados: Heart failure patients have significant survival benefits when their implanted cardioverter-defibrillators (ICD) or cardiac resynchronization therapy defibrillators (CRT-D) are fitted with telemonitoring technology that alerts medical experts to potential problems, results of the IN-TIME trial reveal.
    Noticia »

Hot Line III: Late Breaking Trials on Risk Factors and Diabetes

  • Estudio PURE: Contrasting associations between risk factor burden, CVD incidence and mortality in high, middle and low income countries
    Resultados: Despite being weighed down by more cardiovascular risk factors, people living in higher income countries are able to avoid many of the severe and even fatal consequences of cardiovascular disease (CVD) compared to their counterparts in lower income parts of the world.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas »
  • Estudio EXAMINE: Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care in Patients with Type 2 Diabetes Mellitus and Acute Coronary Syndrome
    Resultados: Patients with type 2 diabetes and high cardiovascular risk due to recent acute coronary syndromes had similar rates of cardiovascular events when treated with the anti-diabetic agent alogliptin compared to placebo.
    Noticia » | Diapositivas » | Artículo en NEJM »
  • Estudio SAVOR-TIMI 53: Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus
    Resultados: The study found no excess, or reduction, in the risk of the primary composite endpoint of heart attacks, stroke, or cardiovascular death, which was the primary safety goal of the study. An increase in hospitalization for heart failure in the saxagliptin arm was noted.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas » | Artículo en NEJM »
  • Estudio ASSURE: Effect of an Oral Agent Inducing Apo A-I Synthesis on Progression of Coronary Atherosclerosis
    Resultados: The search continues for an agent that increases high-density lipoprotein (HDL) and reduces arterial plaque, after the experimental apolipoprotein A1 (apoA1) inducer, RVX-208 failed to do so in the ApoA1 Synthesis Stimulation and Intravascular Ultrasound for Coronary Atheroma Regression Evaluation (ASSURE) study.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas »
  • Estudio COMPARE: Effect of losartan on aortic dilatation rate in adults with Marfan Syndrome
    Resultados: A common drug that is used to treat high blood pressure in the general population has been found to significantly reduce a dangerous and frequently fatal cardiac problem in patients with Marfan syndrome.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas » | Artículo en Eur Heart J »

Hot Line IV: Late Breaking Trials on Heart Failure and Acute Coronary Syndrome

  • Centenary of the Tour de France Group: Mortality of French Participants from the Tour de France 1947-2012
    Resultados: French participants in the Tour de France between 1947–2012 lived longer than their same-age French counterparts.
    Noticia » | Comentario del Investigador Principal y Discusión » | Artículo en Eur Heart J »
  • Estudio ATOMIC-AHF: Acute Treatment with Omecamtiv Mecarbil to Increase Contractility in Acute Heart Failure
    Resultados: Omecamtiv mecarbil, a cardiac myosin-activator, did not achieve its primary efficacy endpoint in reducing dyspnoea (shortness of breath) in patients with acute heart failure.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas »
  • Estudio EchoCRT: The Echocardiography Guided Cardiac Resynchronization Therapy in patients with a narrow QRS
    Resultados: The widespread off-label use of CRT in patients with narrow QRS should no longer be used as an option for patients with a QRS below 130msec, regardless of mechanical dyssynchrony. This trial serves as a reminder that in clinical medicine adequately powered definitive clinical outcome trials are needed before we expand the use of an apparently favourable therapy.
    Noticia » | Diapositivas »
  • Estudio AQUARIUS: Effect of the Renin Inhibitor Aliskiren on Progression of Coronary Atherosclerosis
    Resultados: The blood pressure lowering drug aliskiren did not improve coronary artery disease when given to patients who had prehypertension.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas »
  • Estudio BIC-8: Instant early rule-out using cardiac troponin and copeptin in low- to intermediate-risk patients with suspected ACS: A prospective, randomized multicenter study
    Resultados: An emergency department strategy that uses two biomarkers to triage patients with suspected acute coronary syndrome (ACS) can increase the rate of early, safe hospital discharge.
    Noticia » | Comentario del Investigador Principal y Discusión » | Diapositivas »

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