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Interventional Cardiology

Review | Bail-out techniques in percutaneous intervention for Ellis Grade III coronary perforation in left main distal bifurcation lesions

29 May, 2023 | 10:51h | UTC

Bail-Out Techniques in Percutaneous Intervention for Ellis Grade III Coronary Perforation in Left Main Distal Bifurcation Lesions – JSCAI

 

Commentary on Twitter

 

SCAI Consensus Statement | Management of in-stent restenosis and stent thrombosis

22 May, 2023 | 13:41h | UTC

SCAI Expert Consensus Statement on Management of In-Stent Restenosis and Stent Thrombosis – Journal of the Society for Cardiovascular Angiography & Interventions

News Release: Guidance on management of in-stent restenosis and stent thrombosis – Society for Cardiovascular Angiography and Interventions

 

Stent angioplasty in coronary artery anomalies with intramural course: when, why, how, with what results?

16 May, 2023 | 14:38h | UTC

Stent Angioplasty in Coronary Artery Anomalies With Intramural Course: When, Why, How, With What Results? – Journal of the Society for Cardiovascular Angiography & Interventions

 

Commentary on Twitter

 

Review | Dilemmas in cardiology: when to recanalize a chronic total occlusion

12 May, 2023 | 13:19h | UTC

Dilemmas in cardiology: when to recanalize a chronic total occlusion – European Heart Journal Supplements

See all articles in the series here

M-A | PCI vs. CABG in non–ST-elevation coronary syndromes and multivessel disease

10 May, 2023 | 15:35h | UTC

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Non–ST-Elevation Coronary Syndromes and Multivessel Disease: A Systematic Review and Meta-Analysis – American Journal of Cardiology

 

Expert Panel | Appropriate use criteria for the management of aortic stenosis

5 May, 2023 | 15:22h | UTC

Appropriate Use Criteria for the Management of Aortic Stenosis: Insight From the Japanese Expert Panel – JACC: Asia

 

Contemporary percutaneous management of coronary calcification: current status and future directions

18 Apr, 2023 | 13:06h | UTC

Contemporary percutaneous management of coronary calcification: current status and future directions – OpenHeart

 

Single arm trial | Safety of metformin continuation in diabetic patients undergoing invasive coronary angiography

12 Apr, 2023 | 13:06h | UTC

Safety of metformin continuation in diabetic patients undergoing invasive coronary angiography: the NO-STOP single arm trial – Cardiovascular Diabetology

 

RCT | Routine invasive approach fails to benefit frail older adults with non–ST-segment elevation acute myocardial infarction

6 Apr, 2023 | 13:23h | UTC

Effect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non–ST-Segment Elevation Acute Myocardial Infarction: A Randomized Clinical Trial – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentary: Routine invasive strategy not associated with improved outcomes in older adults with frailty and non-ST segment elevation acute myocardial infarction – Physician’s Weekly

 

Commentary on Twitter

 

Review | Computed tomographic angiography in coronary artery disease

5 Apr, 2023 | 13:33h | UTC

Computed tomographic angiography in coronary artery disease – EuroIntervention

 

SCAI/HRS Expert consensus statement on transcatheter left atrial appendage closure

31 Mar, 2023 | 13:44h | UTC

SCAI/HRS Expert Consensus Statement on Transcatheter Left Atrial Appendage Closure – JSCAI

Key Points: Consensus Statement on Transcatheter LA Appendage Closure – American College of Cardiology

Commentaries:

SCAI/HRS Consensus Document Covers the Ins and Outs of LAAO – TCTMD

New SCAI/HRS Expert Consensus Statement Addresses Transcatheter LAAC – American College of Cardiology

 

RCT | 3-6 month DAPT noninferior to 12 month DAPT in patients undergoing PCI with third-generation DES

22 Mar, 2023 | 13:29h | UTC

Summary: In a randomized trial involving 2,013 patients across 37 centers in South Korea, researchers compared the effectiveness of 3-6 month dual antiplatelet therapy (DAPT) versus 12 months of DAPT after percutaneous coronary intervention (PCI) using third-generation drug-eluting stents.

The primary outcome was net adverse clinical events (NACE), a composite of cardiac death, target vessel myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, or major bleeding.

The study found that 3-6 month DAPT was non-inferior to 12-month DAPT for NACE (3.7% vs. 4.1%, respectively), with a consistent treatment effect across various subgroups. No significant differences were observed in target lesion failure or major bleeding between the two groups.

Despite these findings, further research is needed to generalize the results to other populations and to determine the ideal regimen for 3-6 month DAPT.

Article: Comparison Of 3-6 Month Versus 12 Month Dual Antiplatelet Therapy After Coronary Intervention Using the Contemporary Drug-eluting Stents With Ultrathin Struts: The HOST-IDEA Randomized Clinical Trial – Circulation (link to abstract – $ for full-text)

Commentary: Short DAPT Noninferior to 1 Year After Ultrathin DES PCI: HOST-IDEA – TCTMD

Related:

Short Duration of DAPT Versus De-Escalation After Percutaneous Coronary Intervention for Acute Coronary Syndromes – JACC: Cardiovascular Interventions

Long-term Effects of P2Y12 Inhibitor Monotherapy After Percutaneous Coronary Intervention: 3-Year Follow-up of the SMART-CHOICE Randomized Clinical Trial – JAMA Cardiology (link to abstract – $ for full-text)

Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial – JAMA

Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention: The SMART-CHOICE Randomized Clinical Trial – JAMA

Comparison of Clopidogrel Monotherapy After 1 to 2 Months of Dual Antiplatelet Therapy With 12 Months of Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome: The STOPDAPT-2 ACS Randomized Clinical Trial – JAMA Cardiology

Six months versus 12 months dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction (DAPT-STEMI): randomised, multicentre, non-inferiority trial – The BMJ

6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial – The Lancet

Dual Antiplatelet Therapy Duration Based on Ischemic and Bleeding Risks After Coronary Stenting – Journal of the American College of Cardiology

 

Commentary on Twitter

 

RCT | A 10-y comparison of paclitaxel-coated balloon, paclitaxel-eluting stent, and plain balloon angioplasty for DES in-stent restenosis

20 Mar, 2023 | 13:42h | UTC

Summary: The ISAR-DESIRE 3 trial aimed to compare the 10-year efficacy and safety of plain balloon (PB), paclitaxel-coated balloon (PCB), and paclitaxel-eluting stent (PES) for percutaneous coronary intervention (PCI) of drug-eluting stent (DES) in-stent restenosis (ISR).

A total of 402 patients with DES-ISR were randomized to the different treatment groups: 134 patients to PB angioplasty (160 lesions), 137 patients to PCB angioplasty (172 lesions), and 131 patients to PES implantation (168 lesions).

PCB angioplasty and PES implantation had comparable 10-year results in the device-oriented composite endpoint including cardiac death, target vessel myocardial infarction, target lesion thrombosis, or target lesion revascularization, and significantly reduced the incidence of repeat target lesion revascularization compared to PB angioplasty alone. However, an excess of mortality within 5 years associated with PES warrants further investigation.

Article: Coronary artery restenosis treatment with plain balloon, drug-coated balloon, or drug-eluting stent: 10-year outcomes of the ISAR-DESIRE 3 trial – European Heart Journal (free for a limited period)

 

Commentary on Twitter

 

Review | Transcatheter interventions for heart failure

17 Mar, 2023 | 12:44h | UTC

Transcatheter interventions for heart failure – EuroIntervention

 

RCT | Three-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients with aortic stenosis

14 Mar, 2023 | 13:47h | UTC

Three-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis – Journal of the American College of Cardiology (link to abstract – $ for full-text)

News Release: Benefits of TAVR Remain Consistent in Patients at Low Surgical Risk at Three Years – American College of Cardiology

 

Commentary on Twitter

 

RCT | Immediate complete revascularization non-inferior to staged approach in ACS patients with multivessel disease

13 Mar, 2023 | 15:10h | UTC

Summary: Patients with an acute coronary syndrome and multivessel disease not presenting with cardiogenic shock usually benefit from complete revascularization by percutaneous coronary intervention (PCI). Complete revascularization involves treating all significant blockages in the coronary arteries, including those not causing symptoms (non-culprit lesions).

The BIOVASC randomized non-inferiority trial investigated whether patients with acute coronary syndrome and multivessel coronary disease should undergo immediate complete revascularization during the index procedure or undergo a staged approach with PCI of the culprit lesion only during the index procedure followed by another procedure within 6 weeks of all non-culprit lesions deemed to be clinically significant. The exclusion criteria were:

  • Previous coronary artery bypass surgery.
  • Cardiogenic shock.
  • Single-vessel coronary disease.
  • The presence of a chronic coronary total occlusion.

A total of 1525 patients with acute coronary syndrome and multivessel coronary disease were randomly assigned to either an immediate complete revascularization group (764 patients) or a staged complete revascularization group (761 patients). The primary outcome was a composite of all-cause mortality, myocardial infarction, unplanned ischemia-driven revascularization, or cerebrovascular events at 1 year after the index procedure. The study found that immediate complete revascularization was non-inferior to staged complete revascularization for the primary outcome.

Article: Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial – The Lancet (free registration required)

News Release: Immediate Complete Revascularization as Safe and Effective as Staged Procedure in Treating Multi-Vessel Disease – American College of Cardiology

Commentaries:

Revascularisation in acute coronary syndromes: change in practice? – The Lancet (free registration required)

No Downside to Immediate Complete Revascularization in ACS: BIOVASC – TCTMD

Percutaneous Complete Revascularization Strategies Using Sirolimus-Eluting Biodegradable Polymer-Coated Stents in Patients Presenting With Acute Coronary Syndrome and Multivessel Disease – BIOVASC – American College of Cardiology

Immediate Complete Revascularization Non-Inferior to Staged Procedure in BIOVASC Trial – HCP Live

Related:

The optimal timing for non-culprit percutaneous coronary intervention in patients with multivessel coronary artery disease: A pairwise and network meta-analysis of randomized trials – Frontiers in Cardiovascular Medicine

Multivessel Versus Culprit-Only Revascularization in STEMI and Multivessel Coronary Artery Disease: Meta-Analysis of Randomized Trials – Journal of the American College of Cardiology

Complete Revascularization During Primary Percutaneous Coronary Intervention Reduces Death and Myocardial Infarction in Patients With Multivessel Disease: Meta-Analysis and Meta-Regression of Randomized Trials – JACC: Cardiovascular Interventions

Complete Revascularization with Multivessel PCI for Myocardial Infarction – New England Journal of Medicine

One-Year Outcomes after PCI Strategies in Cardiogenic Shock – New England Journal of Medicine

PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock – New England Journal of Medicine

 

Cohort Study | Effect of prosthesis-patient mismatch on long-term clinical outcomes after bioprosthetic aortic valve replacement

10 Mar, 2023 | 14:32h | UTC

Summary: The study examined the impact of prosthesis-patient mismatch (PPM) on long-term clinical outcomes following bioprosthetic surgical aortic valve replacement (SAVR). The observational cohort study analyzed data from 16,423 patients who underwent bioprosthetic SAVR in Sweden from 2003 to 2018.

Results showed that increasing grades of PPM were associated with higher long-term mortality and heart failure hospitalization. Severe PPM was linked to an increased risk of heart failure, but moderate PPM did not have significant clinical significance. The study also found that PPM was not associated with aortic valve reintervention. The incidence of moderate and severe PPM has decreased in Sweden since 2013 but remained common.

Article: Effect of Prosthesis-Patient Mismatch on Long-Term Clinical Outcomes After Bioprosthetic Aortic Valve Replacement – Journal of the American College of Cardiology

 

#ACC23 – Single-arm study | Pulsed field ablation shows promise for the treatment of atrial fibrillation

8 Mar, 2023 | 14:08h | UTC

Pulsed Field Ablation for the Treatment of Atrial Fibrillation: PULSED AF Pivotal Trial – Circulation

Commentaries:

PULSED AF ‘Strengthens the Case’ for Pulsed-Field Ablation in AF – TCTMD

PULSED AF Pivotal Trial: New Ablation Technology Found Safe, Effective as AFib Treatment – American College of Cardiology

 

#ACC23 – RCT | Intravascular imaging–guided vs. angiography-guided complex PCI

7 Mar, 2023 | 13:20h | UTC

Intravascular Imaging–Guided or Angiography-Guided Complex PCI – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Randomized Controlled Trial of Intravascular Imaging Guidance Versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention – RENOVATE-COMPLEX-PCI – American College of Cardiology

 

Commentary on Twitter

 

#ACC23 – RCT | Transcatheter repair for patients with tricuspid regurgitation

6 Mar, 2023 | 14:29h | UTC

Transcatheter Repair for Patients with Tricuspid Regurgitation – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

The TRILUMINATE Transcatheter Tricuspid Repair Trial: Positive but No Benefit? – Medscape (recommended reading – free registration required)

TRILUMINATE Pivotal: TEER With the TriClip Benefits Patients With Severe TR – TCTMD

Transcatheter Repair Benefits Quality of Life in Patients with Severe Tricuspid Regurgitation – HCP Live

 

Commentary on Twitter

 

#ACC23 – RCT | Five-year follow-up after transcatheter repair of secondary mitral regurgitation

6 Mar, 2023 | 14:28h | UTC

Five-Year Follow-up after Transcatheter Repair of Secondary Mitral Regurgitation – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

COAPT at 5 Years: MitraClip Still Ahead, but Deaths and Crossovers Cast Shadows – TCTMD

Minimally Invasive Mitral Valve Repair Reduces Hospitalizations and Deaths – American College of Cardiology

 

Commentary on Twitter

 

Consensus Statement | Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation

23 Feb, 2023 | 13:33h | UTC

Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions in collaboration with the ESC Working Group on Cardiovascular Surgery – EuroIntervention

 

2023 ACC/AHA/SCAI Advanced training statement on interventional cardiology

21 Feb, 2023 | 11:52h | UTC

Summary: The American College of Cardiology (ACC), the American Heart Association (AHA), and the Society for Cardiovascular Angiography and Interventions (SCAI) have issued a clinical document that outlines competency-based training requirements for interventional cardiology trainees. The report emphasizes the importance of a comprehensive training program that includes both didactic and hands-on training. The competencies required for interventional cardiologists include the ability to perform complex coronary, peripheral vascular, and structural heart interventions and manage and treat complications that may arise during these procedures.

Article: 2023 ACC/AHA/SCAI Advanced Training Statement on Interventional Cardiology (Coronary, Peripheral Vascular, and Structural Heart Interventions): A Report of the ACC Competency Management Committee – Journal of the American College of Cardiology

Commentaries:

Interventional Cardiology Training Needs Defined for the First Time – TCTMD

ACC, AHA, SCAI Release New Training Guidance For Interventional Cardiology – American College of Cardiology

New Advanced Training Statement on Interventional Cardiology: Key Points – American College of Cardiology

 

M-A | Risk of bias in randomized clinical trials comparing transcatheter and surgical aortic valve replacement

15 Feb, 2023 | 15:52h | UTC

Risk of Bias in Randomized Clinical Trials Comparing Transcatheter and Surgical Aortic Valve Replacement: A Systematic Review and Meta-analysis – JAMA Network Open

Commentary: Major TAVI Studies Have ‘Methodological Issues,’ INTEGRITTY Group Contends – TCTMD

 

Commentary on Twitter

 

SCAI expert consensus statement on percutaneous coronary intervention without on-site surgical backup

14 Feb, 2023 | 10:51h | UTC

SCAI Expert Consensus Statement on Percutaneous Coronary Intervention Without On-Site Surgical Backup – JSCAI

News Release: Consensus statement suggests PCI without surgery on site is as safe as PCI with surgery on site – Society for Cardiovascular Angiography and Interventions

Commentaries:

Interventional cardiologists can safely perform PCI without on-site surgical backup – Cardiovascular Business

SCAI Expert Consensus Statement Supports Safety of PCI Without On-Site Surgery – HCP Live

 

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