Some Important Studies from the SCAI Meeting

                The recent virtual 2020 meeting of the Society for Cardiovascular Angiography and Interventions included a great deal of news worthy of expanded coverage in your journal. The highlights include studies describing several trials: TWLIGHT-SYNERGY, the ISCHEMIA trial, and a network that uses telemedicine to organize care for 100 million myocardial infarction patients.

                TWILIGHT-SYNERGY, a study comparing bioabsorbable versus durable polymer everolimus-eluting stents, was described in abstract #11754, “Safety and efficacy of the bioabsorbable polymer everolimus-eluting stent in high-risk patients undergoing PCI: TWILIGHT-SYNERGY,” Baber U, Dangas G, Sharma S, et al.

                ISCHEMIA, a study of more than 5,000 participants with intermediate left main disease undergoing coronary computed tomography angiography, was described in abstract #11656, “Outcomes with Intermediate Left Main Disease on Coronary CT Angiography in the ISCHEMIA trial (ISCHEMIA Intermediate LM Substudy),” Bangalore S., Spertus J., Stevens S).

                The Latin America Telemedicine Network was described in a study authored by Sameer Mehta, MD, et al (‘The Latin America Telemedicine Network & the Public Good’). The network has functioned between 2013 to present in four countries: Brazil, Colombia, Mexico, and Argentina.

Affordable Care Act Associated with Reduced Cancer Mortality, According to ASCO Presscast

                Approximately 589 cancer deaths could have been prevented in 2017, had all states expanded their Medicaid programs under the Patient Protection and Affordable Care Act (ACA), according to a ‘difference of differences’ study discussed during the recent ASCO presscast, in advance of the 2020 virtual ASCO meeting starting May 29.

Cancer mortality has been declining overall. Between 1999 and 2017, It declined from 64.7 to 46.0 per 100,000 in those 27 states (plus the District of Columbia) that expanded Medicaid, and from 69 to 51.9 per 100,000 in states that did not expand their Medicaid programs under the ACA, according to abstract 2003, “Changes in cancer mortality rates after the adoption of the Affordable Care Act.”

“Twenty million people gained insurance through this legislation,” explained lead author Anna Lee, MD, MPH. “There were an estimated 785 less cancer deaths in states that expanded,” said Lee, who is also a radiation oncology fellow at Memorial Sloan Kettering Cancer Center in New York.

In the study, age-adjusted mortality rates per 100,000 between 1999 and 2017 were gathered from the National Center for Health Statistics. Absolute change in cancer mortality among patients younger than 65 was calculated from 2011 to 2013 and then from 2015 to 2017.

Hispanic patients appeared to reap the greatest benefit from Medicaid expansion, the study suggested.

African-American patients had the highest overall cancer mortality, but are improving at a greater rate than other populations. “This may be why we were unable to find a differential benefit for Medicaid expansion in this population,” noted Lee.

In Lieu of Meeting, Scientific Data from DDW to be Released on Schedule

Digestive Disease Week 2020 has been cancelled, and there will be no virtual meeting. However, in lieu of the conference, scientific data from Digestive Disease Week will be released consistent with the meeting's original schedule

News will be available May 2-5.

#DDW

News from Digestive Disease Week

 World Trade Center First Responders Face Higher Risk of Fatty Liver Disease

               Sept. 11 responders were significantly more likely to develop liver disease than the general population, according to a retrospective study discussed at a recent presscast put on by the organizers of Digestive Disease Week.

                Digestive Disease Week 2020 was canceled, and while there will be no Virtual DDW, the organizers are nevertheless releasing the scientific data that was to be presented, consistent with the meeting's original schedule.

                The rate of toxin-associated fatty liver disease (TAFLD) was nearly 83% among 243 World Trade Center first responders who were referred to a doctor for gastrointestinal symptoms, according to abstract Mo1507. By comparison, the rate among the general population ranges from 24 to 45%.

                Between 80 and 100 million Americans have non-alcoholic fatty liver disease (NAFLD), which is associated with obesity, type 2 diabetes, and metabolic syndrome, according to Mishal Reja, MD, resident physician at the Robert Wood Johnson University Hospital in New Brunswick, New Jersey.

                “TAFLD is associated with many common toxins, such as vinyl chloride, as well industrial solvents and building demolition,” explained Reja, who presented the study.

                Among the first responders, 40% were involved with debris removal, while 30 to 40% had administrative roles, added Reja.

                The researchers expect to begin two prospective studies to confirm the findings within the next month. The studies will seek to enroll between one hundred and two hundred subjects comparing the findings in non-World Trade Center responders, Reja noted.