Some patients with mild heart failure show significant, long-term benefits from cardiac-resynchronization therapy, according to the 7-year results from Boston Scientific‘s (NYSE:BSX) MADIT-CRT clinical trial presented at the American College of Cardiology’s annual meeting over the weekend.

The data showed that patients with a left-branch-bundle block that delays left ventricle contraction had a 41% reduction in the risk of long-term death compared with treatment via an implantable cardiac defibrillator. The CRT-D arm also showed a 62% reduction in the risk of non-fatal heart failure events, according to the study, which was also published in the New England Journal of Medicine.

"The findings of the present study provide evidence that early intervention with CRT-D is associated with a significant long-term survival benefit in patients with mild heart failure who have left ventricular dysfunction and an ECG pattern showing left bundle-branch block. However, there were no beneficial effects on long-term outcomes in patients without left bundle-branch block," the authors wrote. "The long-term survival benefit of CRT-D in patients with left bundle-branch block was consistent in each subgroup analyzed, regardless of sex, QRS duration, and ischemic versus non-ischemic cause of cardiomyopathy.

"Patients and their physicians should be encouraged to see the low mortality rate for heart failure patients receiving CRT-D therapy," Boston Scientific chief medical officer for cardiac rhythm management Dr. Kenneth Stein said in prepared remarks. "The life expectancy of this patient population confirms the need for the Boston Scientific longer lasting battery technology, which can minimize the number of additional device replacements, thus reducing risks to patients and reducing costs for the global health care system."

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Three-month data from Boston Scientific’s Reprise II trial of its Lotus transcatheter aortic valve implant showed 85.4% of patients having no paravalvular aortic regurgitation, the company said.

"In addition, no cases of severe paravalvular aortic regurgitation occurred in any patient at 90 days. There were two cases of moderate paravalvular aortic regurgitation (2.1%) and in 12.5% of patients, paravalvular regurgitation was considered mild," according to a press release. All-cause mortality at 90 days was 5%, Boston Scientific said.

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Abbott (NYSE:ABT) said 5-year data from its Everest II trial showed that the "clinical benefits provided by MitraClip are durable through 5 years, including reductions in the severity of [mitral regurgitation], improvement in left ventricular dimensions, improvement in [New York Heart Assn.] functional class (an indicator of quality of life), and a low rate of adverse events from 1 to 5 years, with no new or ongoing safety concerns."

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Patient treated with drug-eluting stents showed a lower risk of major cardiovascular events at 1 year compared to patients treated with bare-metal stents, provided they were treated with an individualized course of dual anti-platelet therapy, according to data from the Zeus study.
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The Platinum Workhorse trial showed that Boston Scientific’s platinum-chromium DES fared better than Abbott’s cobalt-chromium DES, BSX said. The BSX stent showed a 23% lower 4-year target lesion revascularization (rate than the Abbott stent, according to a press release.

"This is the lowest TLR rate in any pivotal U.S. Food & Drug Administration trial for a DES at 4 years," Boston Scientific said.

 Are ICD drivers ticking time bombs?

Drs. Joshua Cooper of Temple University and Steven Markowitz of New York-Presbyterian/Weill Cornell Medical College
debated whether implantable cardiac defibrillator patients pose a threat behind the wheel if their ventricular tachycardia hasn’t triggered a shock in the past 3 months.
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