Direct anticoagulant agents were associated with lower long-term mortality in patients with atrial fibrillation discharged after successful transcatheter aortic valve replacement (TAVR) compared with classic vitamin K inhibitors. Optimal anticoagulation in patients with atrial fibrillation (AF) undergoing TAVR is unclear. We are actually just starting to know what the ideal antiplatelet therapy is for patients undergoing…
AHA 2020 | Effect of Evolocumab in Complex Coronary Revascularization
Evolocumab, a PCSK9 inhibitor, has shown significant reduction of complex coronary disease requiring revascularization (be it PCI or CABG). Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors induce plaque regression and could eventually reduce the risk of coronary revascularization, especially complex revascularization. The FOURIER study randomized 27564 patients with stable CAD already on statins to evolocumab…
AHA 2020 | Omega-3 Fatty Acids Provide No Cardiovascular Benefits and Cause More Atrial Fibrillation
Results confirm the interim analysis, whereby the study was suspended for futility. Omega-3 fatty acids do not reduce cardiovascular events in patients with high triglycerides and low HDL. Previous studies, such as REDUCE-IT, had shown positive results, but given this new research (presented at the American Heart Association [AHA] 2020 Congress and simultaneously published in…
AHA 2020 | EMPATROPISM: Empagliflozin in Non-Diabetics with Cardiac Failure
Empagliflozin improves cardiac function, exercise capacity and quality of life in non-diabetic patients with cardiac failure and deteriorated ejection fraction. These findings were presented during the scientific sessions at AHA 2020 and published simultaneously in JACC. EMPATROPISM outcomes are on the same line as other studies using sodium glucose 2 cotransporter inhibitors (SGLT2) which showed…
AHA 2020 | RIVER: Rivaroxaban as Alternative to Warfarin in Patients with Atrial Fibrillation and Bioprosthetic Mitral Valve
Rivaroxaban seems to be a reasonable alternative to warfarin in patients with atrial fibrillation and bioprosthetic mitral valve. These results arise from the RIVER Study presented at the American Heart Association (AHA) 2020 Congress and simultaneously published in the New England Journal of Medicine (NEJM). After 5 years of follow-up, rivaroxaban reached the non-inferiority criterion…
AHA 2020 | Clopidogrel Resists as the Best Option in Elective Patients
High risk patients undergoing elective PCI treated with a more potent antiplatelet scheme (ticagrelor) vs. the classic clopidogrel do not see a benefit in protection against periprocedural events and instead see increased costs and minor bleeding rate. These are the outcomes of the ALPHEUS study presented at AHA 2020 simultaneously published in the Lancet. Ticagrelor…
AHA 2020 | POLYPILL: One Pill Plus Aspirin to Treat Everything
Using only one compressed tablet or pill with a fixed combination of statins, angiotensin-converting enzyme inhibitors, beta-blockers, and diuretics significantly lowered cardiovascular risk in a large population without previous events (primary prevention). However, it presented an intermediate risk of cardiovascular disease onset. The TIPS-3 (The International Polycap Study 3) study had a 2-by-2-by-2 factorial design,…
AHA 2020 | AFFIRM-AHF: Ferric Carboxymaltose and Fewer Hospitalizations for Cardiac Failure
Correcting iron deficiency in patients with cardiac failure might reduce the risk of new hospitalizations according to the AFFIRM-AHF published in the Lancet and presented at AHA 2020. The combined primary end point of death and hospitalizations was not met; yet the study showed a significant reduction of 26% in hospitalization rate. Irrespective of the…
AHA 2020 | Statins: Confirmed Benefits for the Elderly
Elderly patients (>70) with high cholesterol levels have been systematically excluded from randomized studies on statins, despite their higher risk of cardiovascular events. Presented at AHA 2020 Scientific Sessions and published simultaneously in the Lancet, along comes this primary prevention study including patients between 70 and 100 years of age. The use of therapies to…