AHA 2017: New Hypertension Guidelines, COMPASS Costs, Dual Drug Dilemmas, and More

Like me and the rest of the TCTMD news team, many of our readers will have scarcely unpacked from TCT 2017 before shipping out to the American Heart Association (AHA) 2017 Scientific Sessions. I’m still trying to wrap up our news coverage of last week’s meeting in Denver, CO, while trying to get my mind around the onslaught of studies poised for release next week.

Here’s a brief primer of what’s on the agenda in Anaheim, CA.

As in other years, the meeting has a soft opening Saturday with a focus on resuscitation science, allied health, and early career programming, then the official opening midday Sunday.

There are a jaw-dropping 33 presentations designated as late-breaking science, distributed across seven sessions. The first of seven late-breaking clinical trials takes place Sunday afternoon at 3:45 PM, focusing on CABG and electrophysiology periprocedural dilemmas. Included in this batch of studies are: DACAB looking at aspirin plus ticagrelor (Brilinta; AstraZeneca) or ticagrelor alone after CABG; PRESERVE, comparing sodium bicarbonate and N-acetylcysteine for the prevention of serious adverse outcomes following angiography; and BRUISE CONTROL-2, comparing continued versus interrupted non-vitamin K antagonist oral anticoagulants (NOACs) at the time of device surgery.

Late-breaking session 2, at 9 AM Monday morning, is dedicated to prevention, and it includes further analyses from REVEAL, FOURIER, and CANTOS—all three trials having been presented at earlier this year at the American College of Cardiology and European Society of Cardiology (ESC) meetings.

Late-breaking session 3 at 10:45 AM Monday includes three hypertension trials, SPRINT (first presented at AHA 2015), GATEWAY, and the CHINESE-BP trial. As such, the session dovetails nicely with the day’s big-ticket item: the release of the eagerly awaited joint-society guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults. That document is being released as part of a special session taking place Monday afternoon at 2 PM. That session is followed by late-breaking session 4, focused on diabetes drugs and metabolic markers in cardiovascular disease.

For interventional cardiologists, late-breaking sessions 5 and 6, both Tuesday, have the most to offer. Session 5, at 10:45 AM, includes a cost-impact analysis from the COMPASS trial of rivaroxaban (Xarelto; Bayer/Janssen) plus aspirin in patients with coronary and peripheral artery disease as well as subgroup analyses from RE-DUAL PCI. As reported by TCTMD, primary results from both of those trials were first released in August at ESC Congress 2017. Two additional studies in this session are exploring the use of antiplatelet therapy and drug switching in the setting of ACS and acute MI: GEMINI-ACS-1 and PRAGUE-18.

Session 6, at 3:45 PM, includes a 20-year retrospective look from SWEDEHEART at non-ST-elevation MI outcomes related to use of evidence-based treatments, as well as several studies examining ACS and STEMI systems of care in different parts of the world.

The final late-breaking session, Wednesday at 9 AM, explores “innovative therapies and novel applications,” among them an allogenic stem cell study for myocardial regeneration and the REDUCE-LAP-HF trial of a transcatheter interatrial shunt device for the treatment of heart failure.

In all, this year’s AHA meeting promises 26 programming tracks, spanning basic, translational, clinical, and population-based cardiovascular science, that include 5,000 sessions and 4,000 abstracts.

For news as it breaks, visit TCTMD’s AHA 2017 conference page and follow @TCTMD on Twitter.