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AHA 2021 Highlights Podcast

Presented By
Dr Rachel Giles, Medicom
Conference
AHA 2021
  In this episode (30:55 min), Medicom’s correspondent covers 6 presentations from the American Heart Association (AHA) Scientific Sessions 2021, which was held entirely virtually this year from 13-15 November 2021. The topics discussed are:
  1. Novel anticoagulant milvexian efficacious in reducing postoperative VTE Milvexian, a novel factor XIa inhibitor, was associated with a reduced risk of postoperative venous thromboembolism (VTE) after total knee replacement surgery in the phase 2 AXIOMATIC-TKR trial. Moreover, the associated risk of bleeding was low for this treatment. The promising results of this trial confirm the emerging role of factor XI inhibition in anticoagulant agents. There is an interview with Dr. Alexander Blood, after our summaries, taking a deep dive on one of these featured articles.
  2. Early surgery outperforms conservative management in asymptomatic severe aortic stenosis The AVATAR trial demonstrated the benefits of early surgical aortic valve replacement compared with conservative management in patients with asymptomatic severe aortic stenosis with a normal left ventricular function. These results show that surgery is indicated when aortic stenosis is significant, albeit asymptomatic.
  3. Head-to-head: efficacy of dabigatran versus warfarin on cognitive impairment Dabigatran treatment in older patients with atrial fibrillation (AF) or atrial flutter did not result in different cognitive outcomes than warfarin treatment after 2 years, as demonstrated in the phase 4 GIRAF trial. The CAF trial (NCT03061006) and the BRAIN-AF trial (NCT02387229) are other randomised trials currently investigating the effects of direct oral anticoagulants on cognitive functioning in patients with AF.
  4. Remote healthcare programme improves hypertension and lipid control A remote, algorithm-driven programme with over 10,000 enrolled participants was able to reduce hypertension and LDL cholesterol in patients with a high risk for cardiovascular events. The programme may reduce the need for in-person visitations. Moreover, the remote programme could provide equitable care across underserved populations.
  5. External support device for SVG in CABG surgery is promising No significant difference in intimal hyperplasia was reported between supported and unsupported saphenous vein grafts (SVGs) in patients who underwent coronary artery bypass graft (CABG) surgery in the VEST trial. However, the additional sensitivity analysis did show benefits of the externally supported SVG. No safety issues were observed. Further investigation of external graft support devices is warranted.
  6. Novel oral PCSK9 inhibitor shows promising results for hypercholesterolaemia MK-0616, an oral PCSK9 inhibitor in development, was efficacious in lowering LDL cholesterol in patients with hypercholesterolaemia treated with statins. The drug showed a favourable safety profile across two phase 1 trials. An oral PCSK9 inhibitor could help overcome treatment barriers, providing cardiovascular risk reductions for patients with hypercholesterolaemia in an earlier phase.
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