Undeterred by the Iraq war or severe acute respiratory syndrome, cardiologists from around the world returned to the cavernous halls of Chicago's McCormick Place convention center to hear more interesting and, in some cases, surprising results in the "Late-Breaking Trials" sessions. The following summaries provide a sample from 4 days of wide-ranging reports, presenting data on randomized and controlled studies, large and small.
A community smoking ban leads to reduced incidence of acute MI: In a convention dominated by high-tech approaches and devices, the scientific program committee gave high visibility to a decidedly low-tech intervention--a ban on smoking in public establishments in Helena, Montana. Their excitement stemmed from the observed drop of nearly 60% in hospital admissions for acute myocardial infarction (MI) in just 6 months.
The 65,000 citizens of the Helena area are served by a single 99-bed community hospital that carefully records all admissions of patients with a primary or secondary diagnosis of acute MI. In June 2002, a smoke-free ordinance went into effect that banned smoking in the town's workplaces, restaurants, bars, and casinos.
Dr Richard P. Sargent reported that the number of admissions for acute MI rapidly fell from approximately 7 per month to fewer than 4. No correlations could be found with air pollution, seasonal variations, or other possible confounding events in a review of the 4 previous years of hospital records. Nor did records from outside the Helena area show any change in acute-MI admissions.
"These results suggest that a 100% smoke-free ordinance can have an important and immediate effect on myocardial risk," said Dr Sargent. Discussants hailed the "extraordinary results" from the Helena study, concluding that it showed secondhand smoke to be even more toxic than suspected.
Eplerenone shows encouraging results in reducing mortality post-myocardial infarction (MI): An aldosterone receptor blocker approved by the FDA last fall for treating hypertension was reported in a 37-country clinical trial to reduce mortality among patients who had experienced an acute MI resulting in a left...