Advances in the Treatment of Cardiovascular Diseases: Highlights of the American College of Cardiology's 51st Annual Scientific Session

Prescott, Lawrence M. PhD

• This article, which highlights a number of major clinical trials and subgroup analyses of earlier clinical trials for the treatment and prevention of CAD, hypertension, dyslipidemia, MI, ACS, pulmonary hypertension, and CHF, was written by Lawrence M. Prescott, PhD.

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D & MD Newsletter 13(7):p 195-199, July 2002.

• In a subgroup analysis of a major clinical trial, ACE inhibition proved to be as effective in women as in men for reducing the risk of cardiovascular events in high-risk patients without heart failure or left ventricular dysfunction.

• Chronic antioxidant supplementation with vitamin C appears to be effective in improving blood vessel function in diabetics with coronary artery disease (CAD).

• A novel aldosterone blocker alone or in combination with an ACE inhibitor leads to reductions in left ventricular mass and systolic blood pressure, showing positive benefits on lowering blood pressure and thus lessening the possibility of left ventricular hypertrophy.

• A new dual-component, lipid-lowering formulation in one tablet offers a potent treatment option for persons with dyslipidemia.

• The combination of a statin and a selective inhibitor of cholesterol absorption has been shown to significantly improve levels of LDL-cholesterol, HDL-cholesterol, and triglycerides compared to statin treatment alone.

• Results from a large-scale clinical trial pointed out that a well-known antiplatelet agent is significantly more effective than aspirin in preventing a new myocardial infarction (MI) in patients with a prior MI, stroke, or peripheral arterial disease (PAD), whether patients are at low or high risk.

• Addition of a low molecular weight heparin to a GPIIb/IIIa platelet inhibitor significantly improves clinical outcomes and reduces the incidence of major hemorrhage compared to standard therapy with unfractionated heparin, in patients with high risk acute coronary syndrome (ACS).

• Results from a subgroup analysis of a large clinical study comparing the effects of statin therapy with placebo in patients with ACS point out that treatment with statins markedly reduces C-reactive protein, a marker of inflammation, with the reduction in inflammation being linked to clinical benefits seen in the trial.

• An orally active dual endothelial receptor antagonist has been shown to improve right ventricular systolic function and LV early diastolic filling, leading to reverse ventricular remodeling, as well as significant improvement in functional status, in patients with pulmonary arterial hypertension.

• Beta blockade has been clinically demonstrated to be as effective for women with severe congestive heart failure (CHF) as it is in men with comparable CHF, an important finding since earlier studies had suggested that women responded less favorably to beta blocker treatment than did men.

• Angiotensin II receptor blockers (ARBs) markedly improve LF ejection fraction and reduce LV internal diastolic diameter in heart failure patients, resulting in a reduction in combined mortality and morbidity in ARB-treated individuals.

• African-American patients with CHF have comparable benefits as non-African-American patients when treated with a recombinant form of human B-type natriuretic peptide, a matter of some value since African-Americans have problems with a number of drugs used in the treatment of CHF.