Results of the XIMA trial presented at TCT 2012

Study finds drug-eluting stents exhibit some benefits over bare-metal stents in patients over 80, though both demonstrate clinical benefit

2012-10-26

(Press-News.org) MIAMI, FL – OCTOBER 26, 2012 – Rarely tested in patients over the age of 80, a study found that drug-eluting stents exhibited some benefits over bare-metal stents, though both types of stents demonstrated a clinical benefit. Results of the XIMA trial were presented today at the 24th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.

Patients over the age of 80 are often excluded from randomized clinical trials, but this age group represents an increasing proportion of the daily revascularization workload, and in fact the fastest growing segment of the population. Octogenarians are more likely to present with complex coronary disease, anatomically expectant of drug- eluting stenting (DES). However, these same patients are at higher risk of bleeding complications from prolonged dual antiplatelet therapy (DAPT).

XIMA is an international, multicenter, prospective randomized trial to examine the safety and efficacy outcomes among octogenarians with either a bare-metal stent (BMS) or drug-eluting (DES) stent implantation for complex coronary disease in the context of stable angina or an acute coronary syndrome. Heart attack patients were excluded.

The trial enrolled 800 patients aged 80 or above who underwent angiography for stable angina or following an acute coronary syndrome. If the coronary narrowing was deemed suitable for stenting and the lesion was either ≥15mm long and/or ≤3mm diameter, the patient was randomized to receive either BMS or DES. As long as stent deployment was considered feasible, there were no anatomical exclusions to the trial, which could include chronic total occlusions, bifurcations, severe calcification and left main stem lesions.

The primary endpoint of major adverse cardiac events (MACE) occurred in 18.7 percent of the BMS patients and 14.5 percent of the DES patients (p=0.092). Target vessel revascularization was 7 percent in the BMS group and 2 percent in the DES group (p=0.0009). Heart attack occurred in 8.7 percent of the BMS patients and 4.3 percent of the DES patients (p=0.01). There was no difference in mortality between the two groups at one year (7.2 percent vs. 8.5 percent, p=0.5) and no difference in the rates of major bleeding (1.7 percent vs. 2.3 percent, p=0.61).

"Results of the XIMA trial indicate that in patients over the age of 80, bare-metal and drug-eluting stents both offer good clinical results. Overall, patients who received drug-eluting stents experienced less major adverse cardiac events," said lead investigator Adam J. de Belder, MD. Dr. de Belder is Director of the Cardiac Catheter Laboratories at Brighton and Sussex University Hospitals in the United Kingdom.

"There were no differences in mortality between the two groups at one year and no difference in the rates of major bleeding, despite different dual antiplatelet therapy regimes. However there were significantly lower rates of target vessel revascularisation and myocardial infarction among DES-treated patients," said Dr. de Belder.

###The results of the XIMA trial will be presented on Friday October 26, at 11:15 AM EST in the Main Arena (Hall D) of the Miami Beach Convention Center.

The trial was funded by an unrestricted educational grant from Abbott Vascular. Dr. de Belder reported no relevant financial relationships.

About CRF The Cardiovascular Research Foundation (CRF) is an independent, academically focused nonprofit organization dedicated to improving the survival and quality of life for people with cardiovascular disease through research and education. Since its inception in 1991, CRF has played a major role in realizing dramatic improvements in the lives of countless numbers of patients by establishing the safe use of new technologies and therapies in interventional cardiovascular medicine.

Transcatheter Cardiovascular Therapeutics (TCT) is the annual scientific symposium of the Cardiovascular Research Foundation. TCT gathers leading medical researchers and clinicians from around the world to present and discuss the latest developments in the field.

For more information, visit www.crf.org. END

ELSE PRESS RELEASES FROM THIS DATE:

Cost-effective titanium forming

2012-10-26

To all intents and purposes, nothing stands in the way of titanium in terms of becoming a first-choice industrial material. It is a practically unlimited resource; it is stable and lightweight, but also extremely malleable as well as corrosion and temperature resistant. Nevertheless, this white silver lustrous metal remains in the shadows of steel, chrome, nickel and aluminum when it comes to manufacturing. The reason for this is that efficient metal forming processes such as deep drawing or hydroforming can only be used in a very limited way. "Titanium tends to adhere ...

A Viagra follow-up? Drug used to treat glaucoma actually grows human hair

2012-10-26

If you're balding and want your hair to grow back, then here is some good news. A new research report appearing online in The FASEB Journal (www.fasebj.org) shows how the FDA-approved glaucoma drug, bimatoprost, causes human hair to regrow. It's been commercially available as a way to lengthen eyelashes, but these data are the first to show that it can actually grow human hair from the scalp. "We hope this study will lead to the development of a new therapy for balding which should improve the quality of life for many people with hair loss," said Valerie Randall, a researcher ...

Anesthesia type affects outcomes of bilateral knee replacement surgery

2012-10-26

Using regional anesthesia rather than general anesthesia reduces the need for blood transfusions in patients undergoing bilateral total knee replacement, according to a new study by researchers at Hospital for Special Surgery, in New York City. Currently, the majority of bilateral knee replacements in the United States (as well as single knee replacements) are performed under general anesthesia, and researchers say that a regional anesthesia known as neuraxial anesthesia should be promoted for these procedures. "The use of neuraxial anesthesia may not always be feasible ...

Glass: Characterizing with precision and efficiency

2012-10-26

At home, in the car or with industrial processes – glass is a universal material. Its properties are so extraordinary that frequently there are no alternatives to this material. Take, for example, high-temperature fuel cells, in which layers of ceramics and metals are alternately attached to each other: to ensure no explosive hydrogen escapes, the metal and ceramic layers must be firmly bound to each other, and the seam must be sealed tight. Only glass can accomplish this type of seal – and here, we are specifically referring to solder glass. But how does glass behave at ...

Scientists step up hunt for bacterial genes tied to Lyme disease

2012-10-26

Investigators at The University of Texas Health Science Center at Houston (UTHealth) have accelerated the search for the bacterial genes that make the Lyme disease bacterium so invasive and persistent. The discovery could advance the diagnosis and treatment of this disease, which affects an estimated 30,000 Americans each year. The researchers have developed a new technique that allowed them to test 15 times more bacterial genes than had been evaluated in the previous 30 years to ascertain their roles in infection. Findings appeared Oct. 25 in the journal The Public Library ...

Hermit crabs socialize to evict their neighbors

2012-10-26

Social animals usually congregate for protection or mating or to capture bigger prey, but a University of California, Berkeley, biologist has found that the terrestrial hermit crab has a more self-serving social agenda: to kick another crab out of its shell and move into a larger home. All hermit crabs appropriate abandoned snail shells for their homes, but the dozen or so species of land-based hermit crabs – popular terrarium pets – are the only ones that hollow out and remodel their shells, sometimes doubling the internal volume. This provides more room to grow, more ...

NASA sees Tropical Storm Son-tinh moving through South China Sea

2012-10-26

NASA's Terra satellite got a good look at Tropical Storm Son-tinh moving through the South China Sea and headed for landfall in Vietnam. NASA's Terra satellite flew over Son-Tinh on Oct. 26 at 0305 UTC (Oct. 25 at 11:05 p.m. EDT) and the Moderate Resolution Imaging Spectroradiometer (MODIS) instrument aboard captured a visible image of the storm. At the time, Son-tinh's western edge had already moved away from the Philippines. The image revealed powerful thunderstorms in the northwestern quadrant of the storm, and in the storm's center. On Oct. 26 at 1500 UTC, Tropical ...

Drug shows promise in animal model of Alzheimer's and Parkinson's with dementia

2012-10-26

New research presented in October at the 6th Neurodegenerative Conditions Research and Development Conference in San Francisco demonstrates the role of the investigational compound IRX4204 in alleviating cognitive decline in animal models of Alzheimer's disease (AD). The presentation entitled "Investigation of the RXR-specific agonist IRX4204 as a Disease Modifying Agent of Alzheimer's Disease Neuropathology and Cognitive Impairment" was made by lead researcher Giulio Maria Pasinetti, MD, PhD, of the Mount Sinai School of Medicine in New York City. IRX4204 is a retinoid ...

Stroke survivors who smoke raise risk of more strokes, heart attack, death

2012-10-26

Stroke survivors who smoke put themselves at a greater risk of additional strokes, heart attack or death than those who never smoked, according to new research in the American Heart Association's journal Stroke. Those who quit smoking before their stroke also had less risk of poorer outcomes than current smokers, researchers found. Researchers in Melbourne, Australia, tracked 1,589 patients who experienced a first or recurrent stroke in 1996-99. They followed them for 10 years, using medical records and in-person and telephone interviews, and tracked demographics, ...

C'est difficile

2012-10-26

In a new study out today, researchers used mice to identify a combination six naturally occurring bacteria that eradicate a highly contagious form of Clostridium difficile, an infectious bacterium associated with many hospital deaths. Three of the six bacteria have not been described before. This work may have significant implications for future control and treatment approaches. The researchers found that this strain of C. difficile, known as O27, establishes a persistent, prolonged contagious period, known as supershedding that is very difficult to treat with antibiotics. ...

Results of the XIMA trial presented at TCT 2012

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: