Cardio Round-up: IMPROVE-IT Insights, Stroke Treatment Time Improvement, and More

This week’s edition features a look at research on the IMPROVE-IT population and a potential benefit for elderly patients, a paper showing improved outcomes with improved stroke treatment time, and research on how silent heart attacks are linked to sudden cardiac death.


Simvastatin-Ezetimibe Combo Shows Benefit in Elderly ACS Patients

This follow-up study to the IMPROVE-IT trial looked primarily at elderly patients with acute coronary syndromes who were treated with a statin combination (simvastatin plus ezetimibe) or simvastatin alone. The researchers focused on patients in the older age groups, and particularly those of 75 years or more. Patients of 75 years of age or more saw the most significant improvement relative to younger age groups, according to the results. “The combination of ezetimibe and statin lead to an absolute risk reduction of 9% for the primary endpoint (the overall risk reduction was 2% absolute in the trial as a whole),” Christopher Cannon, MD, of Harvard Medical School, told DocWire News. “Of note, this group (75 years of age or more) started the trial with an average age of 79 and were followed for average of six years (until age 85) and they saw all this benefit! This tells me that we need to treat our elderly patients, as they benefit greatly.”

Improving Stroke Treatment Time Improves Outcomes: Analysis

This study suggested that an improvement in the time it takes from stroke until treatment begins is important, and improvements of as little as 15 minutes can save lives. The JAMA analysis looked at 6,756 patients with acute ischemic stroke, looking specifically at patients in the Get With The Guidelines-Stroke registry. The researchers reported that increments of 15 minutes were associated with improved odds of achieving independent ambulation, and reductions in in-hospital mortality and intracranial hemorrhage as well. “Among patients with acute ischemic stroke due to large vessel occlusion treated in routine clinical practice, shorter time to endovascular-reperfusion therapy was significantly associated with better outcomes,” thee researchers wrote in their conclusion. “These findings support efforts to reduce time to hospital and endovascular treatment in patients with stroke.”

Silent Heart Attacks linked to Sudden Cardiac Death

This paper suggested that many individuals who suffer from sudden cardiac death had experienced prior silent myocardial infarctions. The paper, published in JAMA Cardiology, was a case-control study that included patients from the Finnish Genetic Study of Arrhythmic Events. Researchers examined autopsy findings, clinical characteristics, and ECG markers of 5,869 individuals (79% male, mean age 65) who suffered sudden cardiac death with coronary artery disease and evidence of a silent myocardial infarction. “A substantial number of individuals who experienced coronary artery disease–associated sudden cardiac death had had prior myocardial infarction without a diagnosis of coronary artery disease, the researchers wrote. “Some of these individuals might have been identifiable by pre-mortem electrocardiography.”