Cardiology News / Recent Literature Review / Third Quarter 2016

HCS Panhellenic Congress: Athens, 20-22/10/2016TCT Conference: Washington, DC, 29/10-2/11/2016AHA Scientific Sessions: New Orleans, 12-16/11/2016AF Symposium: Orlando, 12-14/1/2017ACC.17: Washington, DC, 17-19/3/2017HRS Scientific sessions: Chicago, 10-13/5/2017EHRA Europace-Cardiostim: Vienna, 18-21/6/2017ESC Congress: Barcelona, 26-30/8/2017POST 2 Study: Patients with Vasovagal Syncope Improved Modestly with Fludrocortisone 0.2 mg daily with Insignificant 31% Reduction in the Hazard of Fainting in the Intent-to-Treat AnalysisAmong 210 patients (71% female, median age 30 years) with recurrent vasovagal syncope randomized to fludrocortisone or placebo at highest tolerated doses from 0.05 mg to 0.2 mg daily, there was a marginally nonsignificant reduction in syncope in the fludrocortisone group (hazard ratio - HR: 0.69; p = 0.069). In a multivariable model, fludrocortisone significantly reduced the likelihood of syncope (HR: 0.63; p = 0.024). When the analysis was restricted to outcomes after 2 weeks of dose stabilization, there was a significant benefit due to fludrocortisone (HR: 0.51; p = 0.019) (Sheldon R et al, J Am Coll Cardiol 2016;68:1-9).Patients With Variant Angina Presenting With Aborted Sudden Arrhythmic Death (SCD) Face a Worse Prognosis Than Those Without SCD, While Therapy With Vasodilator Drugs is not Sufficiently Protective/ Additional ICD Implantation Might be Necessary as a Secondary Prevention Treatment Among 188 patients with variant angina with atherosclerosis (ASCD) and 1,844 patients with variant angina without ASCD (predictors of ASCD: age, hypertension, hyperlipidemia, family history of sudden cardiac death, multivessel spasm, and left anterior descending artery spasm), over a median of 7.5 years, the incidence of cardiac death was higher in ASCD patients (24.1 vs 2.7 per 1,000 patient-years; hazard ratio - HR: 7.26; p< 0.001). Death from any cause also occurred more frequently in ASCD patients (27.5 vs 9.6 per 1,000 patient-years; HR: 3; p< 0.001). The incidence rate of recurrent ventricular tachyarrhythmia in ASCD patients was 32.4 per 1,000 patient-years, and the composite of cardiac death and ventricular tachyarrhythmia was 44.9 per 1,000 patient-years. A total of 24 ASCD patients received ICDs (Ahn JM et al, J Am Coll Cardiol 2016; 68:137-145.)... (excerpt)