New secondary prevention treatment trial underway

Published: 18 February 2019

Within two years of having a heart attack up to one in five people in New Zealand experience further problems needing repeat admissions to hospital or even death.

Now, a significant grant from the Estate of Ernest Hyam Davis and The Ted and Mollie Carr Endowment Trust, administered by Perpetual Guardian, will help New Zealand take part in an international multi-centre trial to explore the role of opening up all blocked arteries following a heart attack to reduce ongoing problems

Ffr-gUidance for compLete non-cuLprit REVASCularization (FULLREVASC) – a randomised clinical trial, is led in Aoteroa by cardiologist’s Dr Gerry Devlin and Dr Ralph Stewart, with all interventional cardiology units invited to participate.

Standard procedure following a heart attack sees the blocked artery responsible for the heart attack opened. However, Dr Devlin says uncertainty remains as to how best to treat other arteries with blockages.

“Some evidence suggests these arteries should also be opened up as early as possible with the expectation this strategy will reduce problems in the future,” he says.

“The FULLREVASC trial, led out of Karolinska, Sweden, will look at this approach with the addition of a measurement of pressure across the blocked segment, which guides us as to whether or not treatment with stents is needed.

The number of patients needed to answer the important question of possible benefit of opening all blocked arteries after a heart attack, makes it difficult to complete the trial in any one country alone.”

The trial’s strategy will then be compared with a “watch and wait” approach. Participants will be followed up for a minimum of 12 months after their heart attack.

Dr Devlin, who is also the Heart Foundation’s medical director, believes the FULLREVASC trial will benefit all New Zealanders presenting with a heart attack by informing best practice.

“The trial, which assesses the role of revascularisation in secondary prevention, also strongly aligns with the Heart Foundation’s purpose to stop New Zealanders dying prematurely from heart disease and enable people with heart disease to live full lives.”

The recent Health Loss in New Zealand Report (1990–2013) from the New Zealand Burden of Diseases, Injuries and Risk Factors Study, estimates that heart disease is by far the leading specific cause of health loss in New Zealand, in regards to healthy life that is lost due to early death, illness or disability.

Perpetual Guardian, who administers the Estate of Ernest Hyam Davis and The Ted and Mollie Carr Endowment Trust, manage the largest number of registered Charitable Trusts in New Zealand. Its vision, as New Zealand’s premier provider of estate planning services, is for stronger communities where everyone thrives, and works to align the wishes for the settlors to achieve this outcome.

The Heart Foundation is very grateful to the Estate of Ernest Hyam Davis, The Ted and Mollie Carr Endowment Trust and Perpetual Guardian for their support of this important research project. Thanks to the generosity of individuals, trusts and organisations more than $70million has been invested into world-class heart research and specialised training for cardiologists since 1968. 

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