Editor's picks: impactful articles in interventional cardiology
Stay up to date with new literature, studies and trials published in major journals
Struggling to keep up with the mass of scientific information in interventional cardiology? On this page you will find a selection of recent articles published in major journals in the field - use it to guide your reading!
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
March 2018, The Lancet, Joo-Yong Hahn et al.
Available data about the optimal duration of DAPT in patients with acute coronary syndrome undergoing percutaneous coronary intervention are scant. This study sought to investigate whether a 6-month duration of DAPT would be non-inferior to the conventional 12-month or longer duration of DAPT in this population.
Pharmacogenomic approach to selecting antiplatelet therapy in acute coronary syndromes: PHARMCLO trial
March 2018, JACC, Francesca Maria Notarangelo et al.
Clopidogrel is still frequently used in patients with acute coronary syndromes (ACS), but its efficacy is hampered by interpatient response variability, due to genetic polymorphisms associated with clopidogrel metabolism. This study sought to evaluate whether selecting antiplatelet therapy (clopidogrel, prasugrel or ticagrelor) on the basis of a patient’s genetic and clinical characteristics leads to better clinical outcomes in comparison with the standard of care, which bases the selection on clinical characteristics alone.
Effect of loading dose of Atorvastatin prior to planned percutaneous coronary intervention on major adverse cardiovascular events in acute coronary syndrome: the SECURE-PCI randomized clinical trial
March 2018, JAMA, Otavio Berwanger et al.
The effects of loading doses of statins on clinical outcomes in patients with acute coronary syndrome (ACS) and planned invasive management remain uncertain. This study sought to determine if periprocedural loading doses of atorvastatin decrease 30-day major adverse cardiovascular events (MACE) in patients with ACS and planned invasive management.
Ticagrelor vs Clopidogrel after fibrinolytic therapy in patients with ST-elevation myocardial infarction: a randomized clinical trial
March 2018, JAMA, Otavio Berwanger et al.
The bleeding safety of ticagrelor in patients with ST-elevation myocardial infarction treated with fibrinolytic therapy remains uncertain. This study sought to evaluate the short-term safety of ticagrelor when compared with clopidogrel in patients with ST-elevation myocardial infarction treated with fibrinolytic therapy.
A multidisciplinary approach on the perioperative antithrombotic management of patients with coronary stents undergoing surgery
March 2018, JACC: Cardiovascular Interventions, Roberta Rossini et al.
An update on practical recommendations for standardizing management of antithrombotic therapy management in patients treated with coronary stents in various types of surgery, according to the predicted individual risk of thrombotic complications against the anticipated risk of surgical bleeding complications.
Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data
February 2018, The Lancet, Stuart J. Head et al.
The optimal revascularisation strategy in patients with coronary artery disease has been debated for a few decades. The aim of this study was to perform a systematic review and meta-analysis of randomised trials comparing CABG and PCI using stents.
A Comparison of Reduced-Dose Prasugrel and Standard-Dose Clopidogrel in Elderly Patients with Acute Coronary Syndromes Undergoing Early Percutaneous Revascularization
February 2018, Circulation, Stefano Savonitto et al.
Elderly patients are at elevated risk of both ischemic and bleeding complications after an acute coronary syndrome (ACS). Prasugrel 5 mg provides more predictable platelet inhibition, as compared to clopidogrel, in the elderly, suggesting the possibility of reducing ischemic events without increasing bleeding. This study sought to demonstrate the superiority of prasugrel 5 mg over clopidogrel 75 mg.
Safety and Effectiveness of Second-Generation Drug-Eluting Stents in Patients With Left Main Coronary Artery Disease
February 2018, Journal of the American College of Cardiology, Pil Hyung Lee et al.
Limited data are available on the relative performances between different types of drug-eluting stents (DES) for obstructive left main coronary artery disease (LMCAD). This study sought to compare effectiveness and safety profiles of various second-generation DES for LMCAD in real-world clinical practice.
February 2018, Journal of the American College of Cardiology, Ioanna Kosmidou et al.
This study sought to determine the incidence of new-onset atrial fibrillation following percutaneous coronary intervention and coronary artery bypass grafting for left main coronary artery disease and its effect on 3-year cardiovascular outcomes.
Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention After Acute Coronary Syndromes
7 February 2018, JAMA Cardiology, Mauro Chiarito et al.
A systematic review and meta-analysis to evaluate the safety and efficacy of direct oral anticoagulants in addition to antiplatelet therapy after acute coronary syndromes, focusing on treatment effects stratified by baseline clinical presentation (non–ST-segment elevation ACS vs ST-segment elevation myocardial infarction).
Ticagrelor for Secondary Prevention of Atherothrombotic Events in Patients With Multivessel Coronary Disease
February 2018, Journal of the American College of Cardiology, Sameer Bansilal et al.
Patients with prior myocardial infarction (MI) and multivessel coronary disease (MVD) are at high risk for recurrent coronary events. The authors investigated the efficacy and safety of ticagrelor versus placebo in patients with MVD in the PEGASUS-TIMI 54 trial.
30 January 2018, Circulation, Ziad A. Ali et al.
The Absorb bioresorbable vascular scaffold (BVS) completely resorbs within 3 years after coronary artery implantation. The safety and effectiveness of BVS through this critical 3-year period have not been characterized.
1-Year Outcomes of Patients Undergoing Primary Angioplasty for Myocardial Infarction Treated With Prasugrel Versus Ticagrelor
4 January 2018, Journal of the American College of Cardiology, Zuzana Motovska et al.
Early outcomes of patients in the PRAGUE-18 (Comparison of Prasugrel and Ticagrelor in the Treatment of Acute Myocardial Infarction) study did not find any significant differences between 2 potent P2Y12 inhibitors.