Interventional cardiology

News in brief: Gender disparity in post-MI therapy; NSTEMI interventions in very elderly; Apabetalone prevents COVID-19 cardiac injury

Gender disparity in cardiovascular preventive treatments

Australian women are less likely than men to receive guideline-recommended preventive medication following a heart attack or stroke, a new study shows.

Date from 8,278 patients who had a major cardiovascular event showed that 51% of women and 58% of men were using both blood-pressure- and lipid-lowering medications three months after a MI or stroke event, decreasing to 48% and 53%, respectively, at 12 months after an event.

Adjusting for potential confounders, women were 9% less likely than men to be using both medications and 19% more likely to use neither medication three months after a MI or stroke event.

Invasive NSTEMI management benefit irrespective of age

Coronary angiography should be investigated in more trials in very elderly patients (over 85) with non‐ST‐elevation myocardial infarction (NSTEMI) because of the good outcomes seen in real world practice, according to cardiologists at Austin Health Melbourne.

In a review of outcomes for 1052 NSTEMI patients over 85 years of age, the 99 (9.4%) patients  who had invasive management showed improved survival without significant differences in bleeding or stroke, they found.

After adjusting for age, functional status, cognition and cardiovascular risk factors, invasive management was the strongest predictor for survival (HR 0.47), they reported in the Internal Medicine Journal

Apabetalone shows promise against COVID-19 cardiac injury

The atherosclerosis therapy apabetalone may have potential in treating cardiovascular inflammatory injury caused by COVID-19, according to work being done at the QIMR Berghofer Medical Research Institute in Brisbane.

The bromodomain inhibitor is being tested by the Cardiac Bioengineering Research Group, using miniature human heart organoids to understand how COVID-19 causes cardiac damage. Associate Professor James Hudson said their research showed that COVID-19 inflammatory factors activated bromodomain protein 4 in the heart ,and also showed that apabetalone was effective at blocking the inflammatory response.

Apabetalone also inhibited the expression of the cell membrane ACE2 receptor which led to reduced SARS-CoV-2 infection in cardiomyocytes which in turn decreased heart damage, he said.

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