The American Heart Association Scientific Sessions 2019 saw many presentations of exciting and practice-changing trials, novel therapeutic approaches currently in development, guidelines updates, a deeper dive in existing management strategies, in addition to cutting-edge fundamental and translational science.
The ISCHEMIA trial, for example, was long anticipated and reported here that invasive treatment is not clearly the best management strategy for higher-risk patients with stable ischaemic heart disease, when compared with conservative medical therapies (like aspirin or statins) coupled with lifestyle advice, except perhaps for angina burden, which seemed to be better served by an invasive approach.
By contrast, the COLCOT trial reported that low-dose colchicine in patients with a recent MI was not only safe but can prevent major adverse CV events compared with placebo by a 28% margin. The wide accessibility of colchicine could make this trial a game changer.
Also, the ORION series of trials clearly demonstrated the safety and efficacy of inclisiran in lowering cholesterol in patients already on maximum tolerated statins. Inclisiran is a novel inhibitor of PCSK9 through short-interfering RNA, that only needs to be injected twice per year, and managed to at least halve the cholesterol in these difficult-to-manage patient cohorts.
These any many other highlights presented at the AHA 2019 are covered in peer-reviewed summaries in the following pages.
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