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BARCELONA -- Defying terrorism in the city where memorials to last week's slain still line Las Ramblas, the European Society of Cardiology meeting gets underway Saturday with the promise of hot trials.
Key headliner leads the opening Hot Line session Sunday, addressing cardiovascular outcomes targeting inflammation directly with an autoimmune drug.
Top-line results already announced paint the trial as positive for canakinumab (Ilaris), reducing the risk of major adverse cardiovascular events among MI survivors with elevated high-sensitivity C-reactive protein.
"The results of CANTOS are eagerly awaited as the culmination of several decades of research from animal and epidemiologic studies that suggest inflammation plays a causal role in atherosclerotic cardiovascular disease," commented Jennifer Robinson, MD, MPH, director of the Prevention Intervention Center at the University of Iowa in Iowa City.
"CANTOS is the final piece of evidence needed to confirm a causal role for inflammation, and will be the first trial of a drug targeting inflammation to reduce cardiovascular events. This is important as we have learned from the HDL story – a large body of evidence from animals and humans supported the role of HDL cholesterol in cardiovascular disease – but randomized trials of drugs to raise HDL-C failed to demonstrate a reduction in cardiovascular outcomes, and for niacin and torcetrapib, trials also found excess harm. This confirms the importance of evaluating safety, and the need to consider the potential for net benefit from any new agent."
Also at that session are the COMPASS trial data, both the main results (comparing rivaroxaban [Xarelto] with or without aspirin against aspirin alone in prevention of heart attacks, stroke or cardiovascular death in patients with coronary or peripheral artery disease) and a substudy looking at coronary and peripheral artery disease patients separately.
"COMPASS may provide a new antithrombotic approach to secondary prevention for patients with stable coronary artery disease or stable peripheral artery disease," Deepak Bhatt, MD, MPH, of Brigham and Women's Hospital in Boston, noted in an email to 51˶.
He also highlighted interim results from the SPYRAL HTN-OFF MED trial being presented Monday, the first results out of a series of trials with a new renal denervation catheter hoped to "show whether more complete renal artery denervation actually works in reducing blood pressure by a clinically worthwhile amount."
An even more controversial topic is slated for Tuesday's Hot Line session: what constitutes a heart-healthy diet, via the
"Ever since the time of Ancel Keys, Paul Dudley White and many others in the 1940s and 1950s, flawed data, political pressure and 'common sense' have led us down the garden path to wrong thinking about diet," Brian Olshansky, MD, of the University of Iowa, said in highlighting it as of particular interest. "It is time to take a hard look at the science, question what has been said before and change the approach ... I strongly suspect that our present dietary recommendations are without basis in fact, need to be overturned in favor of real and substantial evidence, and have caused more harm than good."
In recent years, ESC has claimed the title of largest cardiovascular research meeting in the world. The conference is returning to Barcelona after a generally-agreed upon unsatisfactory venue last year in Rome. Organizers announced the conference would proceed as planned despite the terrorist attack in Barcelona.