Cardiology News /Recent Literature Review / Last 2 Quarters 2014

Abstract

20^thAnnual Boston AF Symposium: Orlando, 8-10/1/15

HCS Working Groups Seminar: Ioannina, 2/2015

ACC: San Diego, 14-16/3/15

HRS: Boston, 13-16/5/15

EuroPCR: Paris, 19-22/5/15

Europace: Milan, 21-24/6/15

ESC: London, 29/8-2/9/15

AFFORD study: n-3 Polyunsaturated Fatty Acids (Fish Oil) do not Reduce Atrial Fibrillation Recurrences

In a double-blind, randomized, placebo-controlled trial of fish oil (4 g/day, docosahexaenoic acid - DHA: eicosapentaenoic acid - EPA 1:2) vs safflower oil placebo in 337 patients with symptomatic paroxysmal or persistent AF followed for 9 ± 4 months, the primary endpoint (time to first symptomatic or asymptomatic AF recurrence lasting >30 s) occurred in 64% of patients in the fish oil arm and 63% of patients in the placebo arm (hazard ratio: 1.10; p= NS). hs-CRP and myeloperoxidase - MPO were normal at baseline and decreased to a similar degree at 6 months. The authors concluded that high-dose fish oil does not reduce AF recurrence in patients with a history of AF not receiving AA therapy, and does not reduce inflammation or oxidative stress markers in this population (Nigam A et al, J Am Coll Cardiol 2014;64:1441-1448).

N.B.: Another randomized study(VITAL - VITamin D and OmegA-3 TriaL) is currently examining the effect of 1 g/d of n-3 PUFAs on AF in a much larger population (N=25,875) without cardiac disease over 5 years.

RELAX-AHF: Serelaxin ReducesMainly Cardiova-scular &Sudden Deaths, Rather than Heart Failure Deaths The RELAX-AHF study showed thatIV serelaxin (recombinant human relaxin-2) compared with placebo reduced mortality at 6 months among 1,161 patients with acute heart failure (HF). In this group there were 107 deaths (9.3%): 37 (35%) from HF, 25 (23%) from sudden death, 15 (14%) from other cardiovascular (CV) causes, 19 (18%) from non-CV causes, and 11 (10%) classified as unknown. The treatment effect of serelaxin was most pronounced on other CV deaths (hazard ratio - HR: 0.29; p= 0.005) and sudden death (HR: 0.46; p= 0.065), with no effect of serelaxin treatment on HF or non-CV deaths. The authors concluded thatthe effects of serelaxin on mortality were mainly due to reduced CV causes and sudden death, without apparent effect on HF deaths (Feleker GM et al, J Am Coll Cardiol 2014;64:1591-1598). N.B.: an ongoing large phase III outcome trial (NCT01870778) will further examine serelaxin’s effect on mortality... (excerpt)