8:30 a.m. - Abstract #3051 (poster) - Cardiac "regeneration" therapy boosts blood flow in ischemia. Japanese researchers report they've been able to improve blood flow to the diseased heart muscle of a small group of patients with blood vessel blockages that cause chest pain (intractable ischemia) using granulocyte colony-stimulating factor (G-CSF). Half of the 22 patients in the study received subcutaneous injections of G-CSF, which earlier experiments have shown can mobilize cardiac muscle and blood vessel "progenitor" cells from bone marrow to stimulate tissue growth. The other 11 patients were controls. SPECT scans performed before and a month after experimental treatment with G-CSF showed "significantly decreased" extent and severity of ischemia in the treated group but no change in the controls. Neither patient group had clotting or other serious complications, nor no significant changes were seen in either group's left ventricular function. G-CSF improved heart blood flow in intractable ischemic heart disease and there was an increase of CD34 positive cell (a marker of endothelial progenitor cells) in the peripheral supple of blood, the scientists reported.
8:45 a.m. - Abstract #2909 - In diabetic women, bypass surgery no better than angioplasty. Previous reports have indicated that long-term survival in diabetics with multi-vessel coronary disease is notably better in those treated with bypass surgery compared to balloon angioplasty. Surprisingly, this supposed advantage does not appear to hold for diabetic women. Researchers studied data on 280 female and 362 male diabetic patients in the Bypass Angioplasty Revascularization Investigation (BARI). Survival after 10 years was lower in diabetic men treated with angioplasty than diabetic men treated with bypass (49 percent vs. 67 percent). But in diabetic women, survival rates were nearly equal for angioplasty (53 percent) and bypass surgery (51 percent). Men's bypass survival advantage appeared limited to those getting an internal mammary artery graft, but use of this conduit didn't improve results in women. Ten-year survival rates remained similar for bypass and angioplasty in diabetic women after adjustments for confounding baseline variables, leading investigators to conclude that risks and benefits of bypass vs. angioplasty "should be reconsidered" in women with diabetes and multi-vessel disease.
10:30 a.m. - Abstract #2800 - Patients with ICDs should remain physically active. Just how risky is strenuous exercise for patients with implantable cardioverter defibrillators (ICDs)? Current guidelines recommend only low-intensity exercise for ICD patients. Yale researchers surveyed 164 ICD patients (76 percent male, average age 57, 60 percent had coronary artery disease). Most had ventricular rhythm irregularities but no other physical limits to their ability to exercise. The median intensity level of exercises performed any time was 5 METS, with regular exercise ranging from walking (3.5 METS) to tennis and basketball (7 METS). Twenty-eight patients said they engage in more risky activities like biking, skiing or water sports. Twenty-three patients experienced 36 shocks from their ICDs, most during vigorous exercise such as running, doing yard work, competitive sports or biking. Median activity level during a shock episode was 5.5 METS. The first high-energy shock restored sinus rhythm in all ventricular tachycardia and ventricular fibrillation patients, and none caused serious injury. "Sports involving vigorous exercise may be safe in selected ICD patients," the study finds.
2 p.m. - Abstract #3544 - Results of hormone replacement study get rapid acceptance. Findings of last year's Women's Health Initiative (WHI) trial that hormone replacement therapy (HRT) with estrogen (E) plus progesterone (P) in post-menopausal women leads to excessive risk of cardiovascular disease is resulting in a "clear global decrease" in the use of HRT, a new study finds. Researchers assessed the impact of the WHI publication among 6,623 women, age 55 and over, taking part in an ongoing international drug trial. They found that 3.4 percent of North American women in that study were on E+P HRT after the WHI report, down from 5.9 percent before the report. Their results indicate a rapid acceptance of the results of the WHI trial both in North America and other countries, the scientists say. And despite a lack of data on effects of HRT with E alone, this therapy also was down in North American women, from 26 percent of post-menopausal women before the WHI report to 17.7 percent after.
2:15 p.m. - Abstract #3099 - Excess daytime sleepiness affects angina patients' quality of life. Sleep disturbances are a common problem among patients with coronary artery disease (CAD). New research finds that excessive daytime sleepiness predicts a poorer quality of life of CAD patients with chronic stable angina (chest pain). The Emory University study of 57 angina patients assessed quality of life (QOL) aspects via standard questionnaires, at baseline and follow-ups of one, three and four months. Extent of daytime sleepiness also was evaluated along with numerous other factors including years with CAD, body mass index and extent of other health problems. After controlling for clinical and demographic variables, researchers found daytime sleepiness to be "a significant negative predictor of QOL" in four statistical models studied. "Daytime sleepiness had pervasive and detrimental effects on chronic angina patients' QOL including generic and disease-specific physical function, disease perception and mental health," the team says, adding that interventions to correct sleep disturbances potentially can improve patients' QOL.