9 key takeaways from AHA 2024 in Chicago
The American Heart Association's Scientific Sessions 2024 conference brought forward groundbreaking research and advancements in cardiovascular medicine. To learn more, Cardiovascular Business spoke to Hadley Wilson, MD, immediate past president of the American College of Cardiology (ACC) and executive vice chair of Atrium Health Sanger Heart and Vascular Institute, about some of the three-day event's most impactful late-breaking trials.
1. SUMMIT trial show weight loss drug aids heart failure patients
The SUMMIT trial assessed the efficacy of GLP-1 receptor agonists, particularly tirzepatide, in obese patients with heart failure with preserved ejection fraction (HFpEF).
Key Findings includes significant weight loss and improved symptoms, such as better six-minute walk distances. There was a reduction in hospitalizations and intravenous diuretic use. A sub-study using cardiac MRI that was also presented as a late-breaker revealed reduced epicardial fat and improved cardiac modeling, offering new clues about mechanisms of symptom improvement.
2. CRISPR therapy for transthyretin amyloidosis
This phase 1 study explored the potential of in vivo CRISPR technology to treat transthyretin amyloidosis with cardiomyopathy (ATTR-CM) using nexiguran ziclumeran (nex-z, also known as NTLA-2001). The study used a single four-hour infusion of altered liver cells to address the gene responsible for amyloid production. Early results suggest promise for future treatments targeting the root cause rather than symptom management.
3. Edoxaban in bioprosthetic surgical valve replacement (ENBALV Trial)
This study compared edoxaban, a novel oral anticoagulant (NOAC), to traditional warfarin in patients with surgical bioprosthetic valves. Edoxaban was as effective as warfarin in preventing thromboembolic events without increasing bleeding risks. Wilson said this is potentially a game-changer due to its ease of use and reduced monitoring requirements that are required when using the current standard of care warfarin.
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4. Artificial intelligence aids echocardiography and other areas of cardiology
The use of AI in cardiology was highlighted in a special session of late-breaking studies. AI that can help automate measurements in echocardiography gained attention through studies such as AI-ECHO and PanEcho. Wilson said the machine learning algorithms were trained on millions of images and showed promise in automating and improving diagnostic accuracy. He said the AI has the potential to help streamline imaging for large patient populations.
The PHARM-HF A&F study evaluated heart failure medication optimization in the Veterans Affairs Health Care System. THE SEISMIC-HF I study looked to the noninvasive assessment of intracardiac filling pressure. All of these studies show that AI can help speed up workflows with accurate, automated assessments.
5. Negative outcomes for post-MI therapies in CLEAR-SYNERGY
The CLEAR-SYNERGY trial evaluated colchicine and spironolactone in post-myocardial infarction patients. Neither drug reduced adverse outcomes, contrary to expectations, and the results suggest these agents may not benefit this population as much as researchers previously thought.
6. Reconditioned pacemakers found to be safe for global use in MHYH trial
This My Heart, Your Heart trial examined the safety of reconditioned pacemakers for patients in low- and middle-income countries. One key finding was the fact that reconditioned devices performed as well as new ones with no increase in infection or complication rates. Wilson said this could be a sustainable solution for underserved regions.
7. REALIZE-K trial is positive for potassium management in heart failure
REALIZE-K evaluated the use of sodium zirconium cyclosilicate to manage hyperkalemia in heart failure patients. It was found to be effective in maintaining normal potassium levels, enabling safer use of essential diuretics such as spironolactone.
8. Polypill success in treating hypertension in TOPSPIN
The TOPSPIN trial investigated combination therapies in single pills for managing resistant hypertension. Wilson noted that polypills containing two or three antihypertensive agents improved adherence and effectively reduced blood pressure. He said this is promising approach for complex cases requiring multiple medications, where compliance is often a big problem.
9. Renewed focus on Lipoprotein (a)
Wilson said a big trend he saw this year was the increasing interest in lipoprotein(a). He said it has garnered significant attention as a cardiovascular risk marker independent of LDL cholesterol. While it is only found in about 20-25% of the population, when present it can be a significant risk modifier. Lp(a) information was the focus of several booths during the conference and on-site blood testing for Lp(a) on the show floor often had lines of up to 100 or more attendees.
Wilson said there is a large amount of anticipation for Lp(a)-lowering therapies that are currently in development. These treatments could have large implications for clinicians going forward.
Wilson emphasized that all of this new research will make a significant impact on the management of cardiovascular disease for years to come. While further studies are needed to confirm these results, he said the presented research highlights a forward-looking trajectory for cardiology.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com