Journal and News Scan

The authors performed a patient-level meta-analysis of six randomized trials comparing left internal mammary artery (LIMA) + saphenous vein graft (SVG) versus LIMA + radial artery graft. In a total of more than 1000 patients and at a follow-up of 60 months, the incidence of adverse cardiac events (death, myocardial infarction, or repeat revascularization) was significantly lower in patients with a radial artery graft as compared with those in the SVG group (hazard ratio, 0.67; 95% confidence interval, 0.49 - 0.90; p = 0.01). Moreover, the patency rate at 50 months of angiographic follow-up was higher in the LIMA + radial artery group. These results emphasize the importance of using more arterial grafts.

The authors retrospectively evaluated the long-term fate of the aortic arch in 168 patients with bicuspid aortic valves who had undergone either ascending aortic (24%) or aortic root (76%) replacement.  At a median follow-up of 5.9 years, the mean aortic arch diameter went from 2.9 cm preoperatively to 3.0 cm at follow-up (p=ns).  The authors conclude that prophylactic arch replacement in this population is not indicated, and perhaps neither is long-term aortic surveillance.

The authors report on a randomized, multicenter, open-label, clinical trial involving 500 patients with 1460 saphenous vein grafts (SVG) who were assigned to three groups: (1) ticagrelor + asprin (ASA), (2) ticagrelor alone, or (3) ASA alone.  Neither patients nor physicians were blinded to the allocation.  The primary outcome was SVG patency at one year, assessed by either coronary angiography or CT angiography.

Results: The SVG patency rates for groups 1,2, and 3 were 88.7%, 82.8%, and 76.5%.  The differences between group 1 and group 3 were significant at p<0.001.  The differences between the remaining groups were not significant.

Conclusion: Among patients undergoing elective coronary artery bypass grafting, the combination of ASA and ticagrelor resulted in higher SVG patency at one year over ASA alone.  Five major bleeding episdoes occurred during one year of follow-up, all in either group 1 or 2.

Patient Care

The Chinese Red Cross has announced that 25 Afghan children with congenital heart disease will receive free medical treatment in China.

The National Health System England has chosen HeartFlow™ FFRct Analysis to be funded through the Innovation and Technology Payment program, which may allow more patients with coronary artery disease to avoid angioplasty.

The Children’s Heart Foundation and the Adult Congenital Heart Association will host a number of Congenital Heart Walks around the US in 2018 to promote disease awareness and to raise funding for research and educational programs.

Drugs and Devices

In the latest development in a patent spat over transcatheter heart valve technologies, the European Patent Office has revoked a patent owned by Edwards Lifesciences in favor of Boston Scientific. In March, however, the US Patent and Trademark Office ruled in favor of Edwards Lifesciences that claims made by Boston Scientific were invalid.

Research, Trials, and Funding

Researchers report that 45% of patients with non-small cell lung cancer who received nivolumab prior to surgery showed a major pathologic response in the resected tumor, presenting their findings at the recent annual meeting of the American Association for Cancer Research.

Cardiome Pharma has completed enrollment for the Phase 4 SPECTRUM study in the EU evaluating vernakalant hydrochloride for recent onset atrial fibrillation.

A recent study of Swedish adults found that nut consumption was inversely associated with one’s risk for atrial fibrillation and for heart failure.