Update of clinical trials from the American College of Cardiology 2003. EPHESUS, SPORTIF-III, ASCOT, COMPANION, UK-PACE and T-wave alternans.
The American College of Cardiology provided much useful new information to inform those who care for patients with heart failure about what they should and should not adopt into current clinical practice. The EPHESUS trial suggests a much wider role for aldosterone antagonists for the management of heart failure and left ventricular systolic dysfunction. SPORTIF-III indicates we may have a safer, simpler warfarin substitute soon. ASCOT reinforces the potential futility of statin therapy unless it is well targeted. The results of the COMPANION study investigating cardiac resynchronisation devices and implantable defibrillators were encouraging but inconclusive and/or hard to interpret. UK-PACE again questions the use of dual chamber pacing. T-wave alternans is an interesting experimental technique that may be useful in selecting which patients need an implantable defibrillator, although the technology needs testing in an appropriate patient population.
Cleland
John G F
JG
Department of Academic Cardiology, Castle Hill Hospital, Cottingham, Kingston upon Hull HU16 5JQ, UK.
Coletta
Alison P
AP
Nikitin
Nikolay
N
Louis
Amala
A
Clark
Andrew
A
D000925:Anticoagulants / Q000627:therapeutic use*; D002304:Cardiac Pacing, Artificial; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D000077545:Eplerenone; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D010138:Pacemaker, Artificial; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000628:therapy; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D014859:Warfarin; D000077545:Eplerenone