DCRI Highlights from AHA Scientific Sessions

From the main stage, presenting late-breaking science to poster presentations and breakout sessions, Duke Clinical Research Institute faculty and fellows were prominently featured throughout the 2022 American Heart Association Scientific Sessions, helping to build the world’s collective knowledge to improve cardiovascular health care for patients around the world.

The DCRI was represented in more than 25 abstract poster sessions, abstract rapid-fire oral sessions, and moderated digital poster sessions. Six faculty members served as presentation panel participants, and 18 presentation sessions had DCRI faculty as moderators during the AHA Scientific Sessions, held Nov. 5-7 in Chicago. Six faculty members also shared late-breaking science results, provided further insight during discussion, and discussed new therapies as part of the main stage events.

DCRI Faculty Present Findings in Late-Breaking Science Sessions and Main Event Presentations 

• In the first late-breaking science session of AHA Scientific Sessions 2022, DCRI’s Robert J. Mentz, MD presented results from the TRANSFORM-HF study, which examined differences between commonly-used diuretics torsemide and furosemide when prescribed to patients with heart failure in the hospital setting. The authors found that the two therapies had no difference in outcomes, suggesting that providers should focus on finding the right dose for patients. Further reading on TRANSFORM-HF results

• A study led by Duke Health researchers found that pre-operative steroids did not reduce complications for pediatric patients undergoing open heart surgery, and were associated with a greater need for insulin therapy compared to patients assigned to a placebo. Secondary results suggest that children with less complex cases undergoing procedures could benefit from steroids, but they are likely to have less impact on more complicated cases, according to lead author of the study, Kevin Hill, M.D., a member of the Duke Clinical Research Institute and chief of the Division of Pediatric Cardiology at Duke University School of Medicine.

• In diagnosing heart disease, a risk analysis strategy is superior to the usual approach of immediately performing functional tests or catheterization for low- to intermediate-risk patients with new-onset chest pain, according to results from the PRECISE trial comparing the two approaches. Presented at AHA Scientific Sessions by study lead Pamela S. Douglas, MD, a member of the Duke Clinical Research Institute and the Ursula Geller Professor of Research in Cardiovascular Diseases at Duke University School of Medicine, the study bolsters a risk-analysis strategy that either defers testing among low-risk patients, or a CT scan with a contrast agent to assess for blockages.
• DCRI’s Jonathan Piccini, MD, MHS, FACC, FAHA, FHRS, presents results from the phase 2 NOVA trial during AHA Scientific Sessions on Nov. 7, 2022.

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  Phase 2 NOVA study results, presented by DCRI faculty member Jon Piccini, MD, revealed no significant differences in the rate of post-operative atrial fibrillation (AF) between two doses of botulinum toxin type A compared with placebo. However, subgroup analyses suggest lower rates of post-operative AF and reduced rehospitalizations in patients undergoing coronary artery bypass surgery and patients older than 65 who received the 125U dose.
• Svati Shah, MD, MHS shared new insights on machine learning in biomarker and metabolic risk profiling in a main event presentation during AHA 2022. “The future of medicine is precision medicine,” said Shah, DCRI faculty member, director of the Duke Kannapolis research program and professor of Medicine, and Biostatistics and Bioinformatics. “Metabolic risk profiling has proven to be a powerful tool for defining changes in cardiac specific metabolism that occur across a broad array of cardiovascular disease states,”
• PREVENT-HD presentation results discussant Renato Lopes, MD, MHS, PhD, noted that the trial’s conclusion — routine antithrombotic use did not improve outcomes in high-risk, ill outpatients with SARS-CoV-2 infection — was the opposite of what was believed at the beginning of the pandemic, providing further evidence for the need of randomized controlled trials.

Patel leads his final AHA Sessions as chair

Manesh Patel, MD, FACC, FAHA, FSCAI, a DCRI faculty member, chief of the Division of Cardiology and the Division of Clinical Pharmacology and the Richard Sean Stack, MD Distinguished Professor in the Duke School of Medicine, as well as chair of the American Heart Association Committee on Scientific Sessions Program, served as one of the primary hosts of the event. Patel moderated many of the conference’s featured presentations and provided the event’s opening and closing remarks. At the conference’s closing session, the program committee presented him with a commemorative plaque honoring his work as chair.

Watch Patel’s key takeaways from AHA Scientific Sessions 2022

DCRI Award Recipients at AHA.22

We’re incredibly proud of DCRI faculty members Pamela Douglas, MD and Svati Shah, MD, MHS. Both received awards during separate events at the AHA Scientific Sessions.

Douglas was selected to receive the James B. Herrick Award for Outstanding Achievement in Clinical Cardiology by the AHA’s Council on Clinical Cardiology. Douglas delivered the James B. Herrick Lecture as part of the AHA’s Council Named Lecture Series held during Sessions. The series features lectures from some of today’s foremost clinicians and researchers as well as those with a lifetime of contributions to the field of cardiovascular disease.

Shah was selected to receive the Genomic and Precision Medicine Mentoring Award by the AHA’s Council on Genomic and Precision Medicine. It was presented to her during the Council’s annual reception held this year in the Field Ballroom at the Hyatt Regency McCormick Place.

More DCRI Research in the News from AHA

• In-hospital peer-to-peer consult may improve guideline-directed therapy in HFrEF, according to DCRI Fellow Vishal Rao, MD, MPH, who shared that clinician level peer-to-peer consultation was found to be associated with greater guideline-directed medical therapy initiation and dose optimization compared with usual care in patients with HFrEF.

• Results from the VICTORIA trial of vericiguat, presented by Stephen Greene, MD, build on knowledge about the drug’s benefit showing that 92% of patients hospitalized for a worsening heart failure event would be eligible to start the therapy and that doing so would reduce their risk of heart failure hospitalization and cardiovascular death.

• Patients with Ejection Fraction ≤30% Have Higher Risk of Death, Heart Failure Hospitalization — DCRI faculty member Stephen Greene, MD, presented data of patients hospitalized for HFrEF, comparing those with EF 31%-40% to patients with EF less than 31%. Patients with EF less than 31% were younger, more likely to be Black, more likely to be male and more likely to received guideline directed medical therapy. They were also at a significantly higher risk of death, heart failure hospitalization, and rehospitalization.

• Cangrelor After Ticagrelor Pretreatment in ACS Might Be OK: SWAP-5 — New results to the SWAP-5 trial showed enhanced platelet inhibition with no drug-drug interactions when switching stable CAD patients from ticagrelor to Cangrelor. DCRI’s Jennifer Rymer, MD, provided clinician insight for TCTMD, saying the results of the trial were reassuring.

• Fully Remote Intervention for Hypertension, Lipids Proves Feasible, Successful in Large, Diverse Health Care Network — DCRI’s Neha Pagidipati, MD, MPH, with former DCRI Director Eric D. Peterson, now of UT Southwestern, provided commentary commending the investigators and their health system, who “demonstrated that a BP and lipid intervention strategy can be delivered at scale by nonphysician health care professionals using algorithmic care and achieved an impressive result.”