title: Clinical trials update from the European Society of Cardiology Congress in Vienna, 2007: PROSPECT, EVEREST, ARISE, ALOFT, FINESSE, Prague-8, CARESS in MI and ACUITY.
abstract: The Clinical Trials described in this article were presented at the Hotline and Clinical Trial Update Sessions of the European Society of Cardiology Congress held in September 2007 in Vienna, Austria. The sessions chosen for this article represent the scope of interest of Cardiovascular Drugs and Therapy. The presentations should be considered preliminary, as further analyses could alter the final publication of the results of these studies. PROSPECT evaluated echocardiographic criteria for optimal selection of patients with moderate to severe heart failure who may benefit from cardiac resynchronisation therapy, however concluded that no single echocardiographic measure can be recommended. EVEREST found that tolvaptan, a vasopressin V(2) antagonist, resulted in early weight reduction and improvement of dyspnoea in patients with acute heart failure, but lacked long term improvement. In ARISE, the anti-oxidant succinobucal did not affect the primary outcome in high risk cardiovascular patients, but improved the combination of cardiovascular death, myocardial infarction and stroke, and diabetic control in diabetics. ALOFT showed that the addition of the renin inhibitor aliskiren to an ACE inhibitor or ARB and a beta-blocker leads to favourable effects on neurohormonal actions in heart failure. FINESSE markedly improved coronary patency before PCI with half-dose reteplase/abciximab in STEMI patients, however without significantly improving short-term outcome. The Prague-8 Study evaluated whether routine clopidogrel administered >6 h pre-angiography would be a safe way to achieve therapeutic drug levels in case a follow-up intervention would be considered immediately, but appeared not justified because of bleeding complications. CARESS in MI showed that high risk patients with evolving STEMI who undergo thrombolytic therapy should undergo PCI early after the thrombolysis. Finally, the ACUITY trial found that in moderate or high risk Non ST elevation ACS patients triaged to PCI, coronary artery bypass graft (CABG) surgery, or medical management, bivalirudin, with or without associated GPIIb/IIIa inhibitor therapy, resulted in a marked reduction of bleeding at 30 days whilst preserving the ischemic and mortality benefit at 1 year follow up.
authors.affiliation: University of London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Recio-Mayoral
authors.forename: J-C
authors.initials: JC
authors.lastname: Kaski
authors.forename: J J V
authors.initials: JJ
authors.lastname: McMurray
authors.forename: J
authors.initials: J
authors.lastname: Horowitz
authors.forename: D J
authors.initials: DJ
authors.lastname: van Veldhuisen
authors.forename: W J
authors.initials: WJ
authors.lastname: Remme
mesh_terms: D000077284:Abciximab; D054058:Acute Coronary Syndrome / Q000188:drug therapy; D000577:Amides / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D000077144:Clopidogrel; D004562:Electrocardiography; D005060:Europe; D005650:Fumarates / Q000627:therapeutic use; D006331:Heart Diseases / Q000188:drug therapy*; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology; D006629:Hirudins; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy; D010446:Peptide Fragments / Q000627:therapeutic use; D011341:Probucol / Q000031:analogs & derivatives / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077602:Tolvaptan
chemical_list: D000577:Amides; D000911:Antibodies, Monoclonal; D001552:Benzazepines; D005650:Fumarates; D006629:Hirudins; D007140:Immunoglobulin Fab Fragments; D010446:Peptide Fragments; D011994:Recombinant Proteins; D000077602:Tolvaptan; C446481:aliskiren; D000077144:Clopidogrel; C471047:succinobucol; D013988:Ticlopidine; D011341:Probucol; C074619:bivalirudin; D000077284:Abciximab