Interventional Cardiology
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
Left heart catheterization complications | ED presentations, evaluation, and management
9 Jan, 2023 | 14:07h | UTCLeft Heart Catheterization Complications: ED Presentations, Evaluation, and Management – emDocs
Consensus Statement | Radiation protection for healthcare professionals working in catheterization laboratories during pregnancy.
9 Dec, 2022 | 13:26h | UTCCommentary: Expert Consensus Advocates for Normalizing Pregnancy in Cath Labs – TCTMD
Commentary on Twitter
A joint statement on radiation risk and the existing data on the experience of radiation-exposed cardiologists who continue to work in cath labs throughout their pregnancies. @SilbermanManzo @alaide_chief #EAPCI #CARDIOTWITTER https://t.co/UvCNN16klW pic.twitter.com/2kKR0KXf1X
— EuroIntervention (@EuroInterventio) November 22, 2022
M-A | Bioresorbable scaffolds vs. drug-eluting stents for patients with myocardial infarction.
22 Nov, 2022 | 13:29h | UTC
RCT | Bivalirudin is superior to heparin in patients with ST-segment elevation myocardial infarction undergoing primary PCI.
15 Nov, 2022 | 13:00h | UTCCommentaries:
BRIGHT-4: Large, ‘Clean’ Trial Clarifies Bivalirudin Benefits in STEMI – TCTMD
M-A | Bioresorbable vascular scaffolds are inferior compared to conventional drug-eluting stents across time.
10 Nov, 2022 | 13:57h | UTC
Commentary on Twitter
Bioresorbable vascular scaffolds #BVS vs. conventional drug-eluting stents #DES across time:
A #metaanalysis of RCTs@banerjeep https://t.co/XyDVI7XNMi pic.twitter.com/AjEPC6Zv3E— Open Heart (@Open_HeartBMJ) October 27, 2022
M-A | Safety and efficacy of interrupting dual antiplatelet therapy one month following percutaneous coronary intervention.
1 Nov, 2022 | 12:14h | UTC
Commentary on Twitter
Interrupting DAPT after 1 month post PCI:
Meta-analysis of 4 RCTs, >25000 pts
Events between 31days and 1yr:
Less bleeding (1.1 vs 1.5%) but no difference in death (1.3 vs 1.6%), MI (1.4 vs 1.2%), ST (0.3 vs 0.2%) or stroke (0.5 vs 0.6%) https://t.co/rdNgCg032B #cardiotwitter pic.twitter.com/yLWREcDzYe— Heeraj Bulluck (@DrHBulluck) October 30, 2022
Under a http://creativecommons.org/licenses/by/4.0/ license
M-A | Coronary perforation incidence, outcomes and temporal trends.
24 Oct, 2022 | 14:10h | UTC