One didn’t have to watch this year’s presidential address to know that this motherhood-and-apple-pie line probably drew enthusiastic applause from both sides of the aisle. Who doesn’t want to reduce costs and medical errors? Who doesn’t want better information technology? Who wouldn’t ardently support a nonbinding resolution to improve the quality of health care, casting political caution to the wind?

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Presenter: William E. Boden, MD, Professor of Medicine and Public Health, University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York

A trial called Clinical Outcomes utilizing Revascularization and Aggressive DrufEvaluation (COURAGE) attempted to determine whether adding PCI to optimal medical therapy would reduce death, MI, or hospitalizations among patients with acute coronary syndrome (ACS). Dr. Bowden, the lead investigator, said that even though PCI had proved effective in lowering the frequency of angina and in improving exercise performance in the short term, there was no evidence that it could reduce death, MI, or hospitalization. By far, he said, most of the one million PCIs performed each year in the U.S. are of a non-emergency nature in patients with stable CAD.

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As the lead investigator of the Thrombin iteceptor Antagonist in Percutaneous Coronary intervention (TRA-PCI) trial, Dr. Moliterno also took up the recurring theme that for patients undergoing PCI, new agents intended to further reduce clinical events without adding a tendency to cause bleeding have been elusive so far.

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Presenter: John R. Crouse III, MD, Wake Forest University School of Medicine, Winston-Salem, North Carolina

In ASTEROID (AStudy To Evaluate the effect of Rosuvastatin On intravascular ultrasound-Derived coronary atheroma burden), measuring carotid artery intima media thickness (CIMT) with intravascular ultrasound (IVUS) was a reliable means of assessing atherosclerosis, itself a predictor of the risk for cardiovascular events. High-risk patients with CAD, as documented by angiography, received rosuvastatin 40 mg (Generic Crestor, AstraZeneca). As assessed by IVUS, aggressive statin therapy helped to promote regression of atherosclerosis.

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Pre-treatment with High-Dose Statins: Improved Outcomes for Acute Coronary Syndrome

Presenter: Germano Di Sciascio, MD, Campus Bio-Medico University, Rome, Italy

In patients with acute coronary syndrome (ACS) who undergo early invasive percutaneous coronary intervention (PCI), giving high-dose statins for a short term may improve outcomes.

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Olmesartan/Hydrochlorothiazide (Benicar HCT) versus Amlodipine/Benazepril (Lotrel)

Presenter: Henry Punzi, MD, Director, Punzi Medical Center and Hypertension Research Institute, Carrollton, Texas Current hypertension guidelines call for a step approach,

beginning first with one drug, then adding others. Advocates of initial combination therapy have long complained that anti-hypertensive monotherapy rarely achieves treatment goals, but they have not had the data to make their case for first-line combination therapy. Results from trials of combination therapy, however, may fill that void.

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Pegylated Interferon with or without Ribavirin for Hepatitis C Viral Infection

Presenter: Mark G. Swain, MD, Professor, Department of Medicine, Gastrointestinal Research Group, University of Calgary, Canada

Because clinical relapse is rare in patients with chronic hepatitis C virus (HCV) infection who achieve a sustained viro-logical response (SVR) with peginterferon alfa-2a (Pegasys), with or without ribavirin (Copegus), both manufactured by Roche, it is possible that these patients might be considered “clinically cured.”

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