Highlights from the Best Poster Award Competition

Does Candesartan Treatment Augment Reverse Remodeling after Aortic Valve Replacement?

Researchers: Dahl J, Videbaek L, Poulsen M, et al.

Purpose: To determine if angiotensin receoptor blockers—shown to induce left ventricular (LV) hypertrophy regression in patients with arterial hypertension—can also have this effect following aortic valve replacement (AVR) for severe aortic stenosis.

Results: After randomizing 114 patients with severe aortic stenosis who were scheduled for AVR to candesartan 32mg once daily or conventional therapy immediately after valve replacement, the researchers found no differences between the patient groups in systolic, diastolic, and pulse pressure. Further, baseline “LV mass index was 134±41 g/m2 with no difference between groups, at 12 months, mean decrease in LV mass index in the control group was 12±28 g/m2 compared with 30±40 g/m2 in the candesartan group, p=0.015. Therefore, at 12 months LV mass index was significantly lower in the candesartan group (103±29 vs. 119±31 g/m2, p=0.01).” Following tissue assessment, the researchers determined that those in the candesartan group experience greater improvements in longitudinal LV systolic function. Thus, they concluded that compared with “conventional management, angiotensin receptor blockade with candesartan after AVR is associated with accelerated reverse LV and left atrial remodeling.”

Cost-effectiveness for Treating Angina by Severity of Angina at Baseline Presentation

Researchers: Zhang Z, Kolm P, Jurkovitz C, et al.

Purpose: To evaluate “the cost-effectiveness of adding [percutaneous coronary intervention (PCI)] to the optimal medical therapy for the clinically significant improvement in angina severity according to baseline score of the Seattle Angina Questionnaire.”

Results: In the trial, the additional cost of PCI was $10,125, with incremental cost-effectiveness ratios ranging from $85,000 to $250,000 for the lowest and middle terciles and from $500,000 to $5 million for the highest terciles. In the highest tercile, the number of patients needed to treat was much greater. The research team concluded that although the cost effectiveness of PCI is greater for patients with severe angina than those with mild or no angina, “it is uncertain that at any level of severity of angina that PCI would make a society willingness-to-pay threshold.”

Percutaneous Coronary Intervention (PCI) With Drug-Eluting Stents (DES) Versus Coronary Artery Bypass Graft (CABG) For Unprotected Left Main Coronary Artery (ULMCA) Disease.Preliminary Results From The Drug Eluting Stent For Left Main Artery (DELTA) Registry

Researchers: Meliga E, Chieffo A, Park S, et al.

Purpose: Because “long-term results from coronary revascularization with drug-eluting stent (DES)] compared to coronary artery bypass grafting (CABG) for unprotected left main coronary artery (ULMCA) disease have not been yet ascertained,” Meliga and colleagues sought to determine the efficacy of PCI and CABG long-term in patients with ULMCA disease.

Results: With favorable long-term clinical results, implantation of drug-eluting stents in ULMCA disease appears encouraging. No differences were seen between the PCI and CABG groups in regards to occurrence of death, cardiac death, and death/MI/CVA accidents.

Enhanced Arteriogenesis Using X-ray Trackable Microencapsulated Mesenchymal Stem Cells with in vivo Viability Estimates in Peripheral Arterial Disease

Researchers: Kedziorek D, Fu Y, Walczak P, et al.

Purpose: To “describe some of the microencapsulation methods and interpret encapsulateted stem cells viability and their impact on arteriogenesis therapy in peripheral arterial disease.”

Results: With an ability to protect mesenchymal stem cells from early cell destruction, microencapsulation enhances viability and contributes to an “improved arteriogenic response for the treatment of PAD.”

Numerous posters were presented during the Best Poster Award Competition today at the 59^th Annual Scientific Session of the American College of Cardiology. Among the highlights were the following.