AHA: American Heart Association Scientific Sessions

Detecting more cases of atrial fibrillation, and at an earlier rate, is key to preventing adverse patient outcomes, said Stephen Voyce, MD, cardiologist and chief of cardiology at Geisinger Community Medical Center for the Geisinger Heart Institute and director of clinical cardiology research.

Based off the rich data available on mavacamten efficacy within subsets of patients with non-obstructive HCM, researchers have designed the next phase of study on this select group, said Stephen Heitner, MD, director of Clinical Trials and director of the Hypertrophic Cardiomyopathy Center at the Oregon Health and Science University.

For patients with obstructive HCM in the PIONEER-OLE study, mavacamten was shown to improve patients' symptoms, reduce LVOT obstruction, and essentially improve myocardial efficiency, said Stephen Heitner, MD, director of Clinical Trials and director of the Hypertrophic Cardiomyopathy Center at the Oregon Health and Science University.

With the expansive growth of the electronic health record in the past decade, the extraction of meaningful use metrics is vital in the transition to value-based care, said Vinay Kini, MD, MS, cardiologist at the UCHealth Heart and Vascular Center–Anschutz Medical Campus.

Mavacamten is a first-in-class small-molecule therapy that reduces the contractility of cardiac muscles by binding with myosin, a protein involved in muscle contraction that is often affected by a gene mutation in hypertrophic cardiomyopathy.

Data from EVAPORATE, presented at the 2019 American Heart Association Scientific Sessions, may be the start of answering a question that has baffled the research community: just how does icosapent ethyl, sold as Vascepa, prevent heart attacks in patients with high triglycerides?

The 2013 ACC/AHA cholesterol guidelines had no significant change in lipid testing behavior, which can be potentially attributed to the varying cholesterol treatment guidelines implemented by organizations, said Sara Levintow, PhD candidate, Department of Epidemiology at the University of North Carolina at Chapel Hill.

By identifying patients at very high risk for atrial fibrillation, preventive measures and screening strategies can be implemented for heightened patient care, said John Pfeifer, MD, MPH, cardiologist at Geisinger Medical Center.

Sunday’s poster session at the 2019 American Heart Association (AHA) Scientific Sessions in Philadelphia, Pennsylvania, included research that addressed disparities in clinical outcomes, healthcare delivery, and access to payer coverage.

Two additional analyses have come from DAPA-HF, a trial released in September that found the sodium glucose cotransporter 2 inhibitor works equally well in patients with and without diabetes in reducing cardiovascular death and heart failure (HF) events in patients with HF with reduced ejection fraction.

Results from ISCHEMIA, funded by the National Heart, Lung, and Blood Institute, are likely to change practice guidelines, according to commenters who took part in Saturday’s packed presentation at the 2019 American Heart Association Scientific Sessions in Philadelphia, Pennsylvania.

Patients without diabetes who have heart failure saw signficant benefits from the sodium glucose cotransporter 2 inhibitor dapagliflozin, prompting a commenter to ask not if more patients should be taking these drugs but when to start patients on them.

Hypertrophic cardiomyopathy can be a debilitating condition that currently has no approved therapies to treat it, highlighting the impact of potential treatments like mavacamten, said Jay Edelberg, MD, PhD, senior vice president of Clinical Development at MyoKardia.

A compelling paradigm is forming in which dapagliflozin can be prescribed not only to prevent heart failure in people with type 2 diabetes, but also in the patients without diabetes, said Kiersten Combs, US vice president of Cardiovascular Metabolism at AstraZeneca.

Reimbursement structures and population demographics change the way hospitals approach heart failure, explained Amar Bhakta, MD, of Rush University Medical Center.

Trial results have shown that alirocumab (Praluent) is safe and effective across patient populations, said Jay Edelberg, MD, PhD, vice president and head of Cardiovascular Development and Cardiovascular Affairs at Sanofi.

A new pathway uses a multidisciplinary team to help reduce 30-day heart failure readmissions, explained Amar Bhakta, MD, of Rush University Medical Center.

As the American Heart Association (AHA) rolls out its new hypertension guidelines, it has developed a 2-pronged approach for how to get the message out and drive awareness about the new guidelines and recommended lifestyle changes, explained Mary Ann Bauman, MD, of AHA.

The new hypertension guidelines made major changes to the classification of blood pressure, in general, and changed the name of one category to convey more importance, explained Robert Carey, MD, MACP, professor of medicine and dean emeritus at the University of Virginia.

New results on alirocumab (Praluent) show that it is safe and effective for patients with familial hypercholesterolemia (FH), and yet these patients are faced with an unprecedented situation where some payers refuse to pay for the therapy, said Jay Edelberg, MD, PhD, vice president and head of Cardiovascular Development and Cardiovascular Affairs at Sanofi.

Reimbursement policy has been a driver of change in the way hospitals handle heart failure patients.

The findings, presented at the 2017 American Heart Association Scientific Sessions, suggest that a "precision medicine" approach to tailoring adherence strategies to individual patients may be needed, according to the study's lead author.

Recent results from a team-based, scalable intervention to promote medication adherence highlighted that the relationship between adherence and clinical outcomes is not always clear cut, said Niteesh Choudhry, MD, PhD, associate professor at Harvard Medical School.

The outcomes in the COMPASS trial of rivaroxaban to treat patients with peripheral artery disease have been very positive, and a new analysis has looked at the cost impact of bringing the drug to market, explained Andre Lamy, MD, MHSc, FRSC, a cardiac surgeon with the Population Health Research Institute in Hamilton, Ontario, Canada.

The analysis presented at the American Heart Association looks strictly at healthcare costs, but a broader cost-effectiveness study is planned that will consider drug costs as well as effect on patient quality of life.

Researchers presenting at the American Heart Association look at specific populations within 2 large diabetes drug trials, CANVAS and EMPA-REG OUTCOME.

The time a patient is in a doctor's office represents a very small window of the body normally, which makes out-of-office blood pressure measurements important to confirm diagnosis of hypertension, explained Paul Whelton, MD, MSc, professor of global public health at Tulane University.

The chair of the guidelines committee said just because it's hard to change diet and exercise habits doesn't mean doctors and patients shouldn't try.

Results from higher-risk subgroups could help clinicians target this cholesterol-fighting therapy to patients who most need it, authors of one abstract say.

The EMPA-REG trial has been a big step forward for clinicians being able to put patients with type 2 diabetes onto treatment that also reduces cardiovascular disease risk, which is the primary cause of death in these patients, explained Eliot A. Brinton, MD, FAHA, FNLA, president of the Utah Lipid Center.