This article provides information and a commentary on landmark trials presented at the American College of Cardiology meeting held in March 2005, relevant to the pathophysiology, prevention and treatment of
heart failure. All reports should be considered as preliminary data, as analyses may change in the final publication. CARE-HF showed that Cardiac Re-synchronisation
Therapy, administered in addition to expert pharmacological management, reduced all cause mortality and CV hospitalisation in patients with moderate or severe
heart failure and cardiac dyssynchrony. The Women's Health Study showed no benefit of
vitamin E supplementation or
aspirin in the primary prevention of CV disease. The
TNT study showed that reducing
LDL cholesterol to levels lower than currently recommended, produced a 22% reduction in the incidence of major cardiovascular events. In COMPASS, an implantable device that continuously monitors intra-cardiac pressures was shown to be safe and to improve care in patients with chronic
heart failure.
Tezosentan failed to show benefit in patients with acute
heart failure in the VERITAS study. The CANPAP study failed to show a benefit of
continuous positive airway pressure on mortality and
heart transplantation in
heart failure patients with central sleep apnoea. EECP
therapy improved exercise capacity but had no effect on peak VO2 in
heart failure patients in the PEECH study. In the PREMIER study the
matrix metalloproteinase inhibitor PG-116800 failed to prevent LV remodelling following
myocardial infarction.