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By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we feature new studies from a pair of European medical meetings. In one, a drug from a new class of medicines significantly helped patients with a common type of heart failure. The other found a connection between poor blood sugar control in those with type 2 diabetes and the failure of heart stents. We also cover a discovery that could provide clues to why older people are more prone to blood clots.

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An experimental drug developed by Cytokinetics helped patients with a common type of heart failure perform everyday tasks more easily in a late-stage trial, according to results presented at a medical meeting.

Patients with hypertrophic cardiomyopathy (HCM) who received aficamten were able to use significantly more oxygen while exercising by the end of the trial compared to patients who received a placebo, researchers reported at the European Society of Cardiology heart failure meeting in Lisbon, Portugal.

“By having more oxygen available during exercise, patients with obstructive hypertrophic cardiomyopathy can more easily walk, perform household chores, and do other everyday tasks,” study leader Dr. Ahmad Masri of Oregon Health and Science University, who coauthored a report of the trial published in The New England Journal of Medicine, said in a statement.

HCM potentially affects about 700,000 Americans and possibly 15 million people worldwide, earlier research has suggested. The disease thickens heart muscles, reduces blood flow out of the heart, causes shortness of breath and reduces the ability to exercise. Some patients undergo surgery to remove excess heart muscle. Others may end up needing a heart transplant.

The Cytokinetics drug is the second in a new class of medicines called myosin inhibitors. The first, mavacamten, sold by Bristol Myers Squibb under the brand name Camzyos, won U.S. approval for treating HCM in 2022.

Everyone in the 282-patient trial underwent cardiopulmonary exercise testing at the start and after 24 weeks of treatment with either aficamten or a placebo.

“The efficacy of aficamten was evident by week 12,” the researchers reported, with significantly greater improvements in the heart’s pumping ability as well as in patients’ health status, and symptoms.

The incidence of adverse events appeared to be similar with aficamten and placebo.

An editorial published with the report says longer follow-up will be needed to see whether the benefits of myosin inhibitors last as long as those of surgeries to trim the heart muscle, which have success rates of up to 95%.

For now, “it seems prudent to continue to use widely available, easy-to-use, cost-effective agents, including beta-blockers and calcium-channel blockers, as first-line therapy in most patients,” it said.

Poor blood sugar control increases the risk that coronary artery stents will fail in people with type 2 diabetes, researchers reported on Tuesday at a medical meeting.

The researchers tracked more than 52,000 patients in Sweden with type 2 diabetes who had a cardiac stent implanted between 2010 and 2020.

In patients with poor glycemic control, the risk of stent failure was 30% higher than in patients with an HbA1c level of less than 7%, the American Diabetes Association’s threshold for the disease.

This was true even after taking patients’ other risk factors into account.

The findings were presented at the European Association for Percutaneous Cardiovascular Intervention annual meeting in Paris and published in the Journal of the American College of Cardiology.

The researchers said further study is needed to “determine whether specific approaches to achieving glycemic control are more efficacious than others” to help keep stents open and in good working order.

Studies in mice may have yielded a clue as to why older people are more prone to blood clotting diseases, according to a report published on Tuesday in Cell.

Clots happen when blood cells called platelets clump together, a process important in curtailing bleeding from wounds. But researchers say they have discovered that older mice also have a distinct population of platelets with “hyperreactive behavior,” meaning they are more prone to clump together.

Like all blood cells, platelets start out as stem cells and mature through a series of intermediary steps, the researchers explained. In older mice, however, some platelets have not taken all the usual steps from the stem cell stage to maturity.

Instead, they took a “shortcut” pathway, researchers said. Platelets that had taken that shortcut were hyperreactive, while platelets that had followed the main maturation pathway behaved like normal platelets.

The researchers are now looking for this secondary population of platelets in human cells.

In the mice, production of the hyperreactive platelets starts around midlife and increases with age.

Researchers do not yet know what triggers some of the stem cells to take the shortcut. But knowing about this secondary population of platelets will help them find new ways to regulate them, the researchers said.

“The question for decades and decades has been: why are aging people at such high risk for excessive blood clotting, stroke, and cardiovascular disease?” study leader Camilla Fosberg of UC Santa Cruz said in a statement.

“We have this discovery of a whole new pathway that progressively appears with aging — troublemakers! That was never part of the discussion.”

This newsletter was edited by Bill Berkrot.

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