Opinion Review
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2024; 16(7): 389-396
Published online Jul 26, 2024. doi: 10.4330/wjc.v16.i7.389
Coronary artery disease and heart failure: Late-breaking trials presented at American Heart Association scientific session 2023
Avilash Mondal, Sashwath Srikanth, Sanjana Aggarwal, Naga R Alle, Olufemi Odugbemi, Ikechukwu Ogbu, Rupak Desai
Avilash Mondal, Department of Internal Medicine, Nazareth Hospital, Philadelphia, PA 19152, United States
Sashwath Srikanth, Department of Internal Medicine, East Carolina University Greenville, Greenville, NC 27834, United States
Sanjana Aggarwal, Department of Internal Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi 110062, India
Naga R Alle, Department of Medicine, Narayana Medical College, Nellore, Andhra Pradesh 524003, India
Olufemi Odugbemi, Department of Internal Medicine, Lincoln Medical Center, Bronx, NY 10451, United States
Ikechukwu Ogbu, Department of Internal Medicine, Mountainview Hospital Sunrise GME, Las Vegas, NV 89108, United States
Rupak Desai, Independent Researcher, Atlanta, GA 30079, United States
Author contributions: Mondal A and Desai R designed the methodology and performed analysis; Srikanth S, Aggarwal S, Alle NR, Odugbemi O and Ogbu I were involved with data curation, visualization, and interpretation, and writing of manuscript; Mondal A, Desai R, and Ogbu I performed reviewing and final editing; All authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ikechukwu Ogbu, MD, Doctor, Department of Internal Medicine, Mountainview Hospital Sunrise GME, 2880 N Tenaya Way, Las Vegas, NV 89108, United States. iogbu832267@gmail.com
Received: December 28, 2023
Revised: May 21, 2024
Accepted: June 5, 2024
Published online: July 26, 2024
Processing time: 208 Days and 16.7 Hours
Abstract

The late-breaking science presented at the 2023 scientific session of the American Heart Association paves the way for future pragmatic trials and provides meaningful information to guide management strategies in coronary artery disease and heart failure (HF). The dapagliflozin in patient with acute myocardial infarction (DAPA-MI) trial showed that dapagliflozin use among patients with acute MI without a history of diabetes mellitus or chronic HF has better cardiometabolic outcomes compared with placebo, with no difference in cardiovascular outcomes. The MINT trial showed that in patients with acute MI and anemia (Hgb < 10 g/dL), a liberal transfusion goal (Hgb ≥ 10 g/dL) was not superior to a restrictive strategy (Hgb 7-8 g/dL) with respect to 30-day all-cause death and recurrent MI. The ORBITA-2 trial showed that among patients with stable angina and coronary stenoses causing ischemia on little or no antianginal therapy, percutaneous coronary intervention results in greater improvements in anginal frequency and exercise times compared with a sham procedure. The ARIES-HM3 trial showed that in patients with advanced HF who received a HeartMate 3 levitated left ventricular assist device and were anticoagulated with a vitamin K antagonist, placebo was noninferior to daily aspirin with respect to the composite endpoint of bleeding and thrombotic events at 1 year. The TEAMMATE trial showed that everolimus with low-dose tacrolimus is safe in children and young adults when given ≥ 6 months after cardiac transplantation. Providing patients being treated for HF with reduced ejection fraction (HFrEF) with specific out-of-pocket (OOP) costs for multiple medication options at the time of the clinical encounter may reduce ‘contingency planning’ and increase the extent to which patients are taking the medications decided upon. The primary outcome, which was cost-informed decision-making, defined as the clinician or patient mentioning costs of HFrEF medication, occurred in 49% of encounters with the checklist only control group compared with 68% of encounters in the OOP cost group.

Keywords: Heart failure; Coronary artery disease; Clinical trials; Myocardial infarction; Cardiovascular outcome; Percutaneous coronary intervention; Blood transfusion; Cardiac transplant

Core Tip: In this review paper, we discuss the late-breaking trials featured in the American Heart Association 2023, spanning various cardiac conditions and interventions. The review sheds light on treatment nuances and underscore the importance of evidence-based medicine.