Hot Topics in ACC 2008

Most of our cardiology consultants are leaving for the American College of Cardiology Annual Scientific Session. According to Heartwire, the following studies will be the hot topics at the event:

1) ENHANCE

Effect of Combination Ezetimibe and High-Dose Simvastatin vs. Simvastatin Alone on the Atherosclerotic Process in Patients with Heterozygous Familial Hypercholesterolemia

• Subjects: 720 patients with heterozygous familial hypercholesterolemia
• pits the combination of ezetimibe and simvastatin (marketed as Vytorin by Schering-Plough) against simvastatin alone
• results reported around two months ago in a press release stating that the drug combination had no benefit
• because of the results, Vytorin has been the target of media scrutiny
• Dr. John Kastelein will be presenting the full results of this controversial trial in the upcoming scientific meeting

2) ON TARGET

ONgoing Telmisartan Alone in combination with Ramipril Global Endpoint Trial

• Subjects: 28,400 patients at high risk for cardiovascular disease from 700 to 800 clinical sites worldwide
• pits the combination of telmisartan and ramipril against ramipril alone
• you can watch the webcast of the unveiling of the trial results at the ON TARGET website on April 1st

3) ACCOMPLISH

Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension

• Subjects: 11,400 hypertensives >55 years of age with evidence of cardiovascular or renal disease or target organ damage
• pits the combination of ACE inhibitor benazepril and a diuretic against the combination of benazepril and the calcium channel blocker amlodipine
• study was terminated early but reason for termination will not be revealed until the scientific meeting [based on the early reports, I think it was terminated because it showed early on that there was a benefit to giving the regimen]

4) REVERSE

REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction

• Subjects: individuals with heart failure NYHA class 1-2 and a prolonged QRS interval
• Devices used: Medtronic InSync(R) family CRT pacemakers or CRT defibrillators
• investigates if cardiac resynchronization therapy (CRT) on top of medical therapy can improve one-year clinical outcomes

There are several more trials mentioned by the Heartwire report but these seem to be the hot topics. I can’t wait to hear from my mentors.