Interventional Cardiology
RCT | Routine invasive approach fails to benefit frail older adults with non–ST-segment elevation acute myocardial infarction
6 Apr, 2023 | 13:23h | UTCEffect 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 on Twitter
A routine invasive strategy did not improve clinical outcomes in frail patients with NSTEMI. Future trials should confirm whether a policy of watchful observation rather than routine invasive management may be effective for these patients. https://t.co/N4hAXg5fid
— JAMA Internal Medicine (@JAMAInternalMed) March 6, 2023
Review | Computed tomographic angiography in coronary artery disease
5 Apr, 2023 | 13:33h | UTCComputed tomographic angiography in coronary artery disease – EuroIntervention
SCAI/HRS Expert consensus statement on transcatheter left atrial appendage closure
31 Mar, 2023 | 13:44h | UTCSCAI/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
RCT | 3-6 month DAPT noninferior to 12 month DAPT in patients undergoing PCI with third-generation DES
22 Mar, 2023 | 13:29h | UTCSummary: 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:
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)
Commentary on Twitter
#OriginalResearch simpub #CircACC23: The HOST-IDEA RCT showed DAPT duration of 3-6mo was non-inferior to 12mo for net adverse clinical events in patients undergoing PCI with 3rd-gen DES @drlsj https://t.co/uD8RKc03Ci pic.twitter.com/DXPvoyiNke
— Circulation (@CircAHA) March 5, 2023
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 | UTCSummary: 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
Coronary artery restenosis treatment with plain balloon, drug-coated balloon, or drug-eluting stent: 10-year outcomes of the ISAR-DESIRE 3 trial ?https://t.co/NHQpCIaNod #EHJ #ESCYoung @ehj_ed @rladeiraslopes
— European Society of Cardiology Journals (@ESC_Journals) March 8, 2023
Review | Transcatheter interventions for heart failure
17 Mar, 2023 | 12:44h | UTCTranscatheter 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 | UTCThree-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
#ACC23/#WCCardio #JACC LBCT SimPub: Data from the Evolut Low Risk trial demonstrated that #TAVR at 3 years showed durable benefits compared with surgery with respect to all-cause mortality or disabling stroke. https://t.co/PtEEFI1P1t#vhdAS #SAVR #CardioTwitter @kashishgoelmd pic.twitter.com/x0milxBGxO
— JACC Journals (@JACCJournals) March 5, 2023
RCT | Immediate complete revascularization non-inferior to staged approach in ACS patients with multivessel disease
13 Mar, 2023 | 15:10h | UTCSummary: 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)
Commentaries:
Revascularisation in acute coronary syndromes: change in practice? – The Lancet (free registration required)
No Downside to Immediate Complete Revascularization in ACS: BIOVASC – TCTMD
Immediate Complete Revascularization Non-Inferior to Staged Procedure in BIOVASC Trial – HCP Live
Related:
One-Year Outcomes after PCI Strategies in 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 | UTCSummary: 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.
#ACC23 – Single-arm study | Pulsed field ablation shows promise for the treatment of atrial fibrillation
8 Mar, 2023 | 14:08h | UTCCommentaries:
PULSED AF ‘Strengthens the Case’ for Pulsed-Field Ablation in AF – TCTMD
#ACC23 – RCT | Intravascular imaging–guided vs. angiography-guided complex PCI
7 Mar, 2023 | 13:20h | UTCIntravascular Imaging–Guided or Angiography-Guided Complex PCI – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In RENOVATE-COMPLEX-PCI, a randomized trial of imaging-guided or angiography-guided PCI for complex coronary lesion revascularization procedures, imaging-guided PCI led to a lower risk of target-vessel failure than angiography-guided PCI. https://t.co/GaE2cthB5t #ACC23/#WCCardio pic.twitter.com/EB1qb9dY21
— NEJM (@NEJM) March 5, 2023
#ACC23 – RCT | Transcatheter repair for patients with tricuspid regurgitation
6 Mar, 2023 | 14:29h | UTCTranscatheter 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
Commentary on Twitter
In the TRILUMINATE trial, patients with tricuspid regurgitation who were treated with transcatheter edge-to-edge repair had more favorable clinical outcomes at 1 year than did patients who received medical therapy. Full trial results: https://t.co/ZWObb9Xl6T #ACC23/#WCCardio pic.twitter.com/O2E9QSumpQ
— NEJM (@NEJM) March 4, 2023
#ACC23 – RCT | Five-year follow-up after transcatheter repair of secondary mitral regurgitation
6 Mar, 2023 | 14:28h | UTCFive-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
Commentary on Twitter
Transcatheter repair of secondary mitral regurgitation for heart failure was associated with a lower rate of hospitalization for heart failure and lower all-cause mortality than medical therapy at 5 years of follow-up.
Full COAPT trial: https://t.co/rcJ6RQEMAX #ACC23/#WCCardio pic.twitter.com/sM8R50oaBq
— NEJM (@NEJM) March 5, 2023
Consensus Statement | Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation
23 Feb, 2023 | 13:33h | UTC
2023 ACC/AHA/SCAI Advanced training statement on interventional cardiology
21 Feb, 2023 | 11:52h | UTCSummary: 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.
Commentaries:
Interventional Cardiology Training Needs Defined for the First Time – TCTMD
M-A | Risk of bias in randomized clinical trials comparing transcatheter and surgical aortic valve replacement
15 Feb, 2023 | 15:52h | UTCCommentary: Major TAVI Studies Have ‘Methodological Issues,’ INTEGRITTY Group Contends – TCTMD
Commentary on Twitter
Trials comparing TAVI vs SAVR show substantial proportions of deviation from assigned treatment, loss to follow-up, and additional procedures, as well as systematic selective imbalance favoring TAVI that might affect internal validity. https://t.co/n7hwTMEPGu
— JAMA Network Open (@JAMANetworkOpen) January 3, 2023
SCAI expert consensus statement on percutaneous coronary intervention without on-site surgical backup
14 Feb, 2023 | 10:51h | UTCCommentaries:
SCAI Expert Consensus Statement Supports Safety of PCI Without On-Site Surgery – HCP Live
Takayasu Arteritis | JACC Focus Seminar
14 Feb, 2023 | 10:39h | UTCTakayasu Arteritis: JACC Focus Seminar 3/4 – Journal of the American College of Cardiology
Related:
Retrospective Study | Outcomes of percutaneous intervention in patients with Takayasu arteritis
14 Feb, 2023 | 10:38h | UTCRelated:
Takayasu Arteritis: JACC Focus Seminar 3/4 – Journal of the American College of Cardiology
M-A | Dual antiplatelet therapy duration after percutaneous coronary intervention in high bleeding risk
8 Feb, 2023 | 12:16h | UTCDual antiplatelet therapy duration after percutaneous coronary intervention in high bleeding risk: a meta-analysis of randomized trials – European Heart Journal (link to abstract – $ for full-text)
Commentary on Twitter
Dual antiplatelet therapy duration after percutaneous coronary intervention in high bleeding risk: a meta-analysis of randomised trials https://t.co/bIX3fAuOEU @escardio #EHJ #ESCYoung #cardiotwitter @ehj_ed @rladeiraslopes pic.twitter.com/WuzOckXpFX
— European Society of Cardiology Journals (@ESC_Journals) December 20, 2022
Cohort Study | Predictors of acute coronary occlusion in patients with out-of-hospital cardiac arrest without ST-segment elevation
3 Feb, 2023 | 14:20h | UTCAcute Coronary Occlusion in Patients With Non-ST-Segment Elevation Out-of-Hospital Cardiac Arrest – Journal of the American College of Cardiology (link to abstract – $ for full-text)
JACC Podcast: Acute Coronary Occlusion in Patients with Non-ST-segment Elevation Out-of-hospital Cardiac Arrest
Commentary: Coronary Occlusion in Patients With Non-ST Elevation Cardiac Arrest – American College of Cardiology
Related:
Emergency vs Delayed Coronary Angiogram in Survivors of Out-of-Hospital Cardiac Arrest: Results of the Randomized, Multicentric EMERGE Trial – JAMA Cardiology (link to abstract – $ for full-text)
Analysis | An easy way to spot bias in observational studies
31 Jan, 2023 | 14:02h | UTCAn Easy Way to Spot Bias in Observational Studies – Sensible Medicine
Commentary on Twitter
Sensible Medicine: An Easy Way to Spot Bias in Observational Studies https://t.co/iDAap0IEvd
— Sensible Medicine (@Sensible__Med) January 30, 2023
M-A | Transcatheter versus surgical aortic valve replacement in lower-risk and higher-risk patients
31 Jan, 2023 | 13:59h | UTCTranscatheter versus surgical aortic valve replacement in lower-risk and higher-risk patients: a meta-analysis of randomized trials – European Heart Journal (free for a limited period)
Commentary on Twitter
Transcatheter versus surgical aortic valve replacement in lower-risk and higher-risk patients: a meta-analysis of randomized trials https://t.co/qiXE9VWx7K @escardio #EHJ #ESCYoung #cardiotwitter @ehj_ed @rladeiraslopes pic.twitter.com/IWeYHM0o6e
— European Society of Cardiology Journals (@ESC_Journals) January 30, 2023
Review | Mitral valve transcatheter edge-to-edge repair
31 Jan, 2023 | 13:40h | UTCMitral valve transcatheter edge-to-edge repair – EuroIntervention
Commentary on Twitter
This State of the Art describes the currently available M-TEER systems and summarises the evidence for M-TEER in both primary mitral regurgitation (PMR) and secondary mitral regurgitation (SMR). #EAPCI #CARDIOTWITTER https://t.co/HVIepnBazw pic.twitter.com/jrE2RO4JPe
— EuroIntervention (@EuroInterventio) January 28, 2023
2023 Guidelines on the diagnosis and management of chronic coronary syndrome
25 Jan, 2023 | 11:25h | UTC