Highlights of American Heart Association Scientific Sessions 2020: a virtual experience.
Highlights of American Heart Association Scientific Sessions 2020: a virtual experience.
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DOI：
10.1093/cvr/cvaa346
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发表时间：
2021-01-01
影响因子：
10.8
通讯作者：
Marian AJ
中科院分区：
文献类型：
--
作者：
Adão R;Marian AJ
2019冠状病毒病疫情令二零二零年成为独特而充满挑战的一年。今年被过度使用的新术语之一是找到“新常态”。事实上，COVID-19极大地改变了科学大会的体验。社交距离和旅行限制迫使国会协调员在取消活动或重新格式化在线演示之间做出坚韧的决定。美国心脏协会（AHA）将2020年科学会议（11月13日至17日）作为100%的虚拟体验，实时和异步地接触到比以往更多的人，通过实时聊天激发科学对话，提供引人入胜的在线参与。会议提出了各种各样的主题，从新的心力衰竭（HF）治疗到COVID-19的心血管受累，以及结构性种族主义的特别关注。AHA科学会议展示了等待的几项临床试验结果。一些令人兴奋的科学包括对初级心血管疾病（CVD）预防的新看法。在一项新的首个国际结局试验TIPS-3中，涉及5000多名具有中等CVD风险但无已知CVD的患者，使用复方制剂（辛伐他汀、阿替洛尔、雷米普利和氢氯噻嗪）联合阿司匹林治疗可降低心血管事件的发生率。在VITAL-Rhythm试验中，涉及超过20000例患者，维生素D3、Omega-3脂肪酸或联合治疗对房颤（AF）的发生率没有影响，房颤是最常见的心律失常，也是发病率和死亡率的主要原因，1中位治疗持续时间为5.3年。同样，在AF领域，SEARCHAF研究表明，与常规护理相比，在无AF病史但卒中风险较高的患者中，加强心律监测可检测到心脏手术后AF的发生率更高。此外，VITAL-AF试验表明，床旁筛查并没有导致初级保健中更多的新AF诊断，而mSToPS研究发现，使用可穿戴心电图贴片进行持续监测确实导致更多的AF检测和更好的结局，强调了使用移动的健康技术在CVD预防/管理中的重要性。2今年的会议增加了我们对HF和射血分数降低患者的管理。GALACTIC-HF试验入组了> 8000例左心室射血分数< 35% and pro-brain natriuretic peptide>400 pg/mL的患者，接受Omecamtiv Mercabil vs.安慰剂治疗。Omecamtiv Mecarbil治疗与主要结局、首起HF事件或CVD原因导致的死亡（以先发生者为准）的适度降低相关。此外，根据涉及1000例患者的AFFIRM-AHF试验结果，近期因急性HF住院的缺铁患者接受定期静脉注射羧基麦芽糖铁治疗，可在52周内适度减少HF再入院，而对死亡率无影响。ALPHEUS研究检查了替格瑞洛在减少接受择期高风险经皮冠状动脉介入治疗（PCI）患者的4型心肌梗死（MI）方面是否上级氯吡格雷，报告称替格瑞洛在减少围手术期肌坏死方面并不上级氯吡格雷。MI伴冠状动脉非阻塞性病变（MINOCA）在女性中经常观察到3，HARP-MINOCA研究显示光学相干断层扫描和心血管磁共振成像的有用性。
The year 2020 has been unique and defiant due to pandemic of COVID-19. One of the new over-used terms this year is finding the ‘new normal’. Indeed, COVID-19 has transformed the scientific congress experience significantly. Social distancing and travel restrictions have enforced congress coordinators to make a tough decision between cancelling the events or re-formatting for online presentations. The American Heart Association (AHA) presented Scientific Sessions 2020 (13–17 November) as a 100% virtual experience, reached more people than ever, in real-time and asynchronously, with live chats that inspire scientific dialogues, providing an engaging online involvement. A wide variety of subjects were presented, ranging from new heart failure (HF) treatments to cardiovascular involvement in COVID-19 and a special focus in structural racism. The AHA Scientific Sessions showcased awaited several clinical trial results. Some of the exciting science included fresh takes on primary cardiovascular disease (CVD) prevention. In a new first-of-its-kind international outcomes trial, TIPS-3, involving more than 5000 patients with an intermediate CVD risk but no known CVD, treatment with a polypill formulation (simvastatin, atenolol, ramipiril, and hydrochlorothiazide), plus aspirin led to a lower incidence of cardiovascular events. In VITAL-Rhythm trial, involving more than 20 000 patients, treatment with vitamin D3, Omega-3 fatty acids, or a combination had no effect on the incidence of atrial fibrillation (AF), the most common cardiac arrhythmia and a major cause of morbidity and mortality, 1 over a median treatment duration of 5.3 years. Likewise, in the AF field, SEARCHAF study demonstrated that enhanced cardiac rhythm monitoring detected a higher incidence of post-operative AF after cardiac surgery, as compared to the usual care, in those who had no history of AF but had a high risk of stroke. Also, the VITAL-AF trial showed that point-ofcare screening did not result in more new AF diagnoses in primary care, whereas mSToPS study found that continuous monitoring with a wearable electrocardiogram patch did lead to more AF detected and even better outcomes, emphasizing the importance of the use of mobile health technology in CVD prevention/management. 2 This year’s sessions added to our armamentarium in the management of patients with HF and reduced ejection fraction. The GALACTIC-HF trial enrolled> 8000 patients with left ventricular ejection fraction< 35% and pro-brain natriuretic peptide> 400pg/mL to received Omecamtiv Mercabil vs. placebo. Omecamtiv Mecarbil treatment was associated with a modest decrease in the primary outcome, the first HF event or death from CVD causes, whichever occurred first. Furthermore, according to results of the AFFIRM-AHF trial involving 1000 patients, treatment of iron-deficient patients, who were recently hospitalized for acute HF, with periodic intravenous administration of ferric carboxymaltose modestly reduced HF readmissions over the course of 52 weeks without an effect on mortality.Relevant clinical trial provided insights into valve and coronary artery disease treatment. The ALPHEUS study, which examined whether ticagrelor was superior to clopidogrel in reducing myocardial infarction (MI) type 4 in patients undergoing elective high-risk percutaneous coronary intervention (PCI), reported that ticagrelor was not superior to clopidogrel in reducing periprocedural myonecrosis. MI with nonobstructive lesions in the coronary arteries (MINOCA) is frequently observed in women 3 and the HARP-MINOCA study showed the usefulness of optical coherence tomography and cardiovascular magnetic …
影响因子：
37.8
作者：
Churchwell, Keith;Elkind, Mitchell S. V.;Williams, Olajide
通讯作者：
Williams, Olajide
影响因子：
158.5
作者：
Amarenco, Pierre;Lavallee, Philippa C.;Wong, Lawrence K. S.
通讯作者：
Wong, Lawrence K. S.
影响因子：
10.8
作者：
Cucchi, Danilo;Camacho-Munoz, Dolores;Mauro, Claudio
通讯作者：
Mauro, Claudio