Cardio Trial Files: Atorvastatin vs. Placebo in Bicuspid Aortic Valve, Apolipoprotein A1 Infusions After MI, and SAVR +/- TAVI in Aortic Stenosis
Atorvastatin Effect on Aortic Dilatation and Valvular Calcification Progression in Bicuspid Aortic Valve (BICATOR)
Evangelista A et al. Circulation (May 2024)
Bottom Line: This randomized clinical trial aimed to determine the effectiveness of atorvastatin in reducing the progression of aortic dilation and valve calcification in patients with bicuspid aortic valve. 220 patients were treated with either atorvastatin or placebo for 3 years. Results showed a significant reduction in low-density lipoprotein cholesterol levels in the atorvastatin group, but no significant difference in aortic diameter or valve calcification progression between the two groups. No significant safety concerns were reported. In conclusion, atorvastatin treatment did not effectively reduce the progression of aortic dilation and valve calcification in this patient population.
Apolipoprotein A1 Infusions and Cardiovascular Outcomes after Acute Myocardial Infarction
Gibson CM et al. NEJM (April 2024)
Bottom Line: This international, double-blind, placebo-controlled trial evaluated the effectiveness of four weekly infusions of 6 g of CSL112, a human apolipoprotein A1 derived from plasma, vs. matching placebo in reducing the risk of recurrent cardiovascular events in patients with acute myocardial infarction, multivessel coronary artery disease, and additional cardiovascular risk factors. The study included 18,219 patients and found no significant difference in the primary outcome of composite of myocardial infarction, stroke, or death from cardiovascular causes between the intervention and control groups at 90, 180, and 365 days of follow-up. Adverse events were similar between the two groups, with a higher number of hypersensitivity events in the intervention group. In conclusion, CSL112 did not show a lower risk of recurrent cardiovascular events compared to placebo in this patient population.
Transcatheter or Surgical Treatment of Aortic-Valve Stenosis
Blankenberg S et al. NEJM (April 2024)
Bottom Line: This randomized noninferiority trial compared TAVI and SAVR in low-risk patients with severe, symptomatic aortic stenosis. A total of 1414 patients were assigned to either TAVI or SAVR, with a primary outcome of death from any cause or fatal or nonfatal stroke at 1 year. TAVI was found to be noninferior to SAVR, with a primary outcome event rate of 5.4% in the TAVI group and 10.0% in the SAVR group (hazard ratio for death or stroke, 0.53; 95% confidence interval [CI], 0.35 to 0.79; P<0.001 for noninferiority). Procedural complications occurred in 1.5% and 1.0% of patients in the TAVI and SAVR groups, respectively. The conclusion of the study was that TAVI was noninferior to SAVR in terms of death from any cause or stroke at 1 year.
Cardio Trial Files Issue #CRD-2024-14
Want to view past issues? Visit our archive: