AHA: American Heart Association Scientific Sessions

The PIONEER AF-PCI trial studied bleeding in patients with atrial fibrillation undergoing percutaneous coronary intervention with 3 different treatments. The study found that a rivaroxaban (Xarelto)-based strategy had a significant reduction of bleeding complications, explained Roxana Mehran, MD, FACC, FACP, professor of medicine and director of Interventional Cardiovascular Research and Clinical Trials at the Zena and Michael A. Weiner Cardiovascular Institute at Mount Sinai School of Medicine.

A study inspired by a patient who could not afford his heart medication shows that there was no pattern to price variability for a common regimen to treat heart failure, which could contribute to poor adherence.

The study now includes 494 patients, and will be complete when 503 are enrolled. Of the participants, 60% required anticoagulant reversal to undergo surgery.

For some time, cardiologists have wondered whether there was anything to be gained by pushing LDL or "bad" cholesterol to very low levels.

A study of a pair of large databases shows a strong link between obesity and heart failure.

The study finds one-quarter of the patients stop taking anticoagulants within 3 months and nearly three-quarters have stopped after 2.25 years.

Presenters noted that this was an important but unusual trial, because it examined drugs not in isolation but how they are used in combination.

The results point to the need for more study on the effects of long-duration blood pressure treatment to prevent cognitive decline, especially in the highest risk patients.

The results from a wide-ranging public health effort in Howard County, Maryland, show a decline in sugary beverage consumption nearly on par with early results from Berkeley, California, which passed the nation's first soda tax.

A review of data of patients with cardiomyopathy found that those who had used marijuana were more likely to be younger males with fewer pre-existing cardiovascular risk factors.

Results released by Sanofi and Regeneron of their PCSK9 inhibitor were based on prior clinical trials.

Studies at the American Heart Association show very different approaches to exercise for type 2 diabetes patients.

Test results presented have implications for patients if they require emergency surgery.

Results show that bleeding was the most common reason patients stopped taking the drug in this study of long-term tolerability.

Commentators called the study the most important blood pressure research in 40 years. Treating systolic pressure to a target of 120 mm Hg did not cause problems for patients with existing chronic kidney disease although there were some signals for those who did not have the disease at baseline.

More details are revealed on the first diabetes drug shown to have a cardioprotective benefit, but Yale's Silvio Inzucchi was cautious about assuming the effect applies to the entire SGLT2 inhibitor class.

Studies that measure the effect of walkable communities in Canada and taking the train in Japan show that added steps to one's routine can have positive effects on heart health.

A study finds that a commonly prescribed therapy reduces activity in patients with heart failure with preserved ejection fraction.

Hospitals that face penalties from CMS for failing to reduce readmission rates have looked to telehealth as a potential tool to keep track of patients after discharge. A study presented by a UCLA researcher did not meet its end point but offered some insights for future work.

Ample evidence supports obesity as an independent risk factor for cardiovascular disease (CVD). Traditionally, obesity is defined by body mass index (BMI); however, recent data suggest metabolic syndrome and excess adipose tissue play more of a role than BMI in determining CVD risk. In this session, Jaime Armando, PhD, and colleagues from the University of Texas Southwestern Medical Center; and Amparo Figueroa, MD, MPH, from Massachusetts General Hospital, presented results from studies that examined the roles of metabolic syndrome and excess adipose tissue in determining CVD risk.

In a presentation titled Readmission for Stroke and Quality of Care Among Hospitalized Patients With Transient Ischemic Attack: Real World Delivery of Care, Emily C. O'Brian, PhD, from Duke University School of Medicine, presented results from the American Heart Association's Get With the Guidelines (GWTG)-Stroke program. GWTG is a hospital improvement program designed to improve adherence to evidence-based care.

In this session, data were presented from 3 separate trials that focused on potential ways to reduce the risk for bleeding in patients who require anticoagulation therapy, including the use of genetic tests to optimize warfarin dosing and the use of the factor Xa inhibitor edoxaban. Munir Pirmohamed, MD, PhD, from the University of Liverpool, discussed results from the EU-PACT trial; Stephen Kimmel, MD, from the University of Pennsylvania School of Medicine discussed results from the COAG trial; and Robert P. Giugliano, MD, SM, FAHA, FACC, from Brigham and Women's Hospital, discussed results from the ENGAGE TIMI-AF 48 trial.

In this session, the efficacy and safety profiles of novel alternatives to warfarin were discussed by Jeffrey Weitz, MD, FACP, from McMaster University. Also discussed was the selection of the right anticoagulant for the right patient.

In this session, Denise Bonds, MD, MPH, from the National Heart, Lung, and Blood Institute, discussed the limitations of outcomes research conducted using claims or registry data. According to Dr Bonds, the trend is to use new data, big data, and patient-powered data. In another presentation, Catarina Kiefe, PhD, MD, from the University of Massachusetts Medical School, provided preliminary findings from her research in patients with acute coronary syndrome as an example of how outcomes research is evolving.

Patients spend far more time in the home than with their healthcare providers, making the home an ideal and perhaps essential place to improve adherence and outcomes. In this session, Kathryn Donofrio, DNP, MBA, RN, from Swedish Covenant Hospital, and Debra Moser, DNSc, MN, RN, from the University of Kentucky, discussed home-based strategies for care improvements in patients with heart failure.

Accountable Care Organizations (ACOs) are designed to improve the quality and continuity of care, but it remains unclear how stakeholders can be successful in this new model and also how the shift in incentives will truly impact care. In this session, W. Douglas Weaver, MD, from the Henry Ford Heart and Vascular Institute and Henry Ford Hospital, and Karen E. Joynt, MD, MPH, from Brigham and Women's Hospital and Harvard Medical School, discussed the potential impact of ACOs on specialty care and the potential for ACOs to limit access to care.

Recently released guidelines from the American College of Cardiology and American Heart Association base treatment on a 10-year risk for atherosclerotic cardiovascular disease, a shift from the previous guidelines' overall emphasis on treat to target. In this session, C. Noel Bairey Mertz, MD, FACC, from the Cedars-Sinai Heart Institute; Jennifer G. Robinson, MD, MPH, from the University of Iowa; and Karol Watson, MD, PhD, FACC, from the University of Southern California, Los Angeles, discussed the evidence supporting cholesterol lowering in women, the elderly, and minorities.

The participants in this session noted that the medical record of the future will likely include a prognostic genetic component that will have short- and long-term implications. Panelists included Jennifer Hall, PhD, FACC, FAHA, from the University of Minnesota; Dan Roden, MD, from Vanderbilt University; Gary H. Gibbons, MD, from the National Heart, Lung, and Blood Institute; and Christopher Cannon, MD, from Brigham and Women's Hospital.