Two steps forward and—well, let’s say one step on pause.
The Heart Rhythm Society (HRS) and the Society for Cardiovascular Angiography and Interventions (SCAI) fulfilled their missions of advancing knowledge in their specialties with scientific sessions that recently concluded. Both programs offered a packed few days of late-breaking clinical trials, symposia, poster sessions and other events.
At HRS.13, Vivek Y. Reddy, MD, of the Cardiovascular Institute at Mount Sinai School of Medicine in New York City, presented four-year results from PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation). The study compared the left atrial appendage Watchman closure device (Boston Scientific) with warfarin in patients with nonvalvular atrial fibrillation who are at risk of stroke. The long-term data showed the Watchman device to be superior to warfarin for primary efficacy and mortality.
At SCAI.13, a CREST (Carotid Revascularization Endarterectomy vs. Stenting Trial) substudy found that performing balloon angioplasty after carotid artery stenting reduced the risk of restenosis by 64 percent but increased the risk of stroke. The stroke finding was not statistically significant, though. Mahmoud B. Malas, MD, chief of endovascular surgery at Johns Hopkins Bayview Medical Center in Baltimore, presented the results at a late-breaking clinical trial session.
Attendees at both conferences likely gained a greater appreciation for registries, based on sessions focused on their importance and findings from studies. At HRS.13, for instance, an analysis of the EFFORTLESS S-ICD Registry containing data from hospitals in Europe and New Zealand showed that 7 percent of patients implanted with subcutaneous implantable cardioverter-defibrillators (S-ICDs) experienced inappropriate shocks.
Credit the National Cardiovascular Data Registry’s ICD registry as the bedrock for a study published in the May 15 issue of the Journal of the American Medical Association. The researchers reported that patients implanted with dual-chamber ICDs had higher rates of complications at one year than did patients who received single-chamber devices.
In another arena, a report released by the Institute of Medicine on sodium intake found evidence for lowering recommended daily sodium consumption wanting. The authors used words like “insufficient,” “inconsistent” and “highly variable” to describe the studies they reviewed. The American Heart Association, which advocates a daily limit of 1,500 mg for the general population, disagreed with the report’s key conclusions.
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Candace Stuart
Cardiovascular Business, editor