Ticagrelor compared against clopidogrel produces more bleeding and also more deaths in patients over 80 recently undergoing acute myocardial infarction. Contrary to what has been observed in the general population, these data from the SWEDEHEART registry of post MI patients over 80, show higher bleeding and mortality rates with ticagrelor compared against clopidogrel. These findings…
ESC 2020 | Antihypertensive Therapy Reduces Events Regardless of BP Levels or Risk
Antihypertensive therapy reduces the risk of cardiovascular events even in patients with no history of heart disease or with normal baseline blood pressure (BP). This fuels a long-running debate about thresholds for hypertension diagnosis (which may or may not exist). Beyond that, the higher the baseline BP, the better the benefit. The decision to prescribe…
ESC 2020 | Rivaroxaban Might Reduce Cardiac Cerebral and Peripheral Events
Adding rivaroxaban to the standard treatment might reduce events incidence in lower limbs, heart, and brain, in patients with peripheral vascular disease undergoing revascularization. These new data resulted from the analysis of the VOYAGER PAD subgroups and were presented at the virtual ESC 2020. The COMPASS study had reached similar conclusions using 2.5 mg rivaroxaban…
ESC 2020 | More Evidence on Colchicine for Chronic Ischemic Heart Disease
According to this new study, colchicine offers some benefit to patients with chronic ischemic heart disease. Similar to COLCOT, this is the second large randomized study with results confirming the inflammatory hypothesis. Colchicine taken at a daily dose of 0.5 mg reduces cardiovascular events in patients with stable coronary disease, according to data from the LoDoCo2…
ESC 2020 | Dapagliflozin in Kidney Failure: The Drug Continues to Conquer Other Territories
The DAPA-CKD trial has shown dapagliflozin, a SGLT2 receptor inhibitor, improves function, and reduces cardiovascular events and mortality. The latter is true regardless being or not diabetic. Patients with chronic kidney failure randomized to dapagliflozin saw improved kidney function, reduced cardiovascular events and increased survival rate. Primary end point, a combination of glomerular filtration deterioration…
ESC 2020 | Against the Grain, ASA Monotherapy Appears Superior after TAVR
After TAVR, patients with no anticoagulation indication are favored by monotherapy with aspirin (ASA) vs. dual antiaggregation therapy (DAPT). This study presented at ESC 2020, simultaneously published in NEJM, seems to go against the latest “fashion” (P2Y12 inhibitor monotherapy) and randomized patients to ASA monotherapy vs. DAPT with clopidogrel for 3 months. Unlike with the…
ESC 2020 | New SGLT2 Inhibitor Impacts Heart Failure Mortality
Empagliflozin is the second drug from the SGLT2 receptor inhibitor family to show a significant benefit in patients with heart failure, even in those without diabetes. Adding empagliflozin to optimal medical therapy lowers the risk of cardiovascular events in patients with heart failure and reduced ejection fraction. Such events include heart failure hospitalization, worsening kidney…
ESC 2020 | New Drug Improves Functional Capacity in Hypertrophic Cardiomyopathy
In patients with hypertrophic cardiomyopathy, myosin inhibitor mavacamten plus optimal medical therapy improved hemodynamics, functional capacity, and symptoms. Mavacamten is the first myosin inhibitor drug of its class. Presented virtually at the European Society of Cardiology 2020 Congress (ESC 2020) and published simultaneously in The Lancet, the EXPLORER-HCM study showed that 37% of patients who received…
ESC 2020 | Atrial Fibrillation and Rhythm Control: A Matter of Time?
Early rhythm control therapy in patients recently diagnosed with atrial fibrillation reduces the risk of cardiovascular events compared against the usual treatment of frequency control. These data come from the EAST-AFNET 4 trial recently presented at ESC 2020, simultaneously published in NEJM. These data suggest that we should offer patients early rhythm control therapy to…