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Interested in following-up on the recent publications in interventional cardiology? Here is a selection of must-read articles published during March 2018
Acute Coronary Syndrome
Correlates of non-target vessel-related adverse events in patients with ST-segment elevation myocardial infarction: insights from five-year follow-up of the EXAMINATION trial
Non-TV-related MI or revascularization in patients who underwent primary PCI for STEMI accounted for the half of all non-fatal cardiac events during 5-year follow-up, and was associated with incomplete revascularization, diabetes and previous MI.
Two-year outcomes of high bleeding risk patients with acute coronary syndrome after Biolimus A9 polymer-free drug-coated stents: a LEADERS FREE substudy
In patients presenting with ACS, drug coated stent (DCS) significantly reduced the occurrence of ischemic events, as compared with a BMS, during 2-year follow-up. Importantly, both groups received only 1-month DAPT.
No Benefit of Ticagrelor Pretreatment Compared With Treatment During Percutaneous Coronary Intervention in Patients With ST-Segment–Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
In STEMI patients undergoing primary PCI, administration of Ticagrelor prior to the catheterization laboratory did not confer additional benefit over Ticagrelor given only in the catheterization laboratory.
Techniques and technology
5-Year Outcome Following Randomized Treatment of All-Comers With Zotarolimus-Eluting Resolute Integrity and Everolimus-Eluting PROMUS Element Coronary Stents
Final Report of the DUTCH PEERS (TWENTE II) Trial
Cobalt chromium-based ZES (Resolute Integrity) and platinum chromium-based EES (Promus Element) showed similar rates of TVF and stent thrombosis (both ≈1.5%) during 5 years follow-up.
Association of Stress Test Risk Classification With Health Status After Chronic Total Occlusion Angioplasty (from the Outcomes, Patient Health Status and Efficiency in Chronic Total Occlusion Hybrid Procedures [OPEN-CTO] Study)
CTO PCI was associated with a reduction in anginal symptoms regardless of the preprocedural stress testing results.
Comparison of drug-eluting stents and drug-coated balloon for the treatment of drug-eluting coronary stent restenosis: A randomized RESTORE trial
In patients with ISR after DES, treatment with a DEB was deemed similar to EES in terms of late lumen loss at 9 months, although the follow-up MLD was larger in patients treated with an EES.
PCI vs. CABG
Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data
CABG was associated with a reduction in mortality in patients with multivessel disease, especially in the presence of diabetes, whereas no difference was found in patients with left main disease.
PCI for stable coronary artery disease
Clinical implications of three-vessel fractional flow reserve measurement in patients with coronary artery disease
The sum of the FFR values from the three major epicardial vessels was shown to be predictive of mortality in patients with at least >30% coronary stenosis on angiography.
Pharmacology for interventional Cardiologists
Short-Term Versus Long-Term Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Elderly Patients
A Meta-Analysis of Individual Participant Data From 6 Randomized Trials
In patients aged ≥65 and treated with a DES, shorter DAPT (≤6 months) was associated with less major bleeding and a similar rate of ischemic events, as compared with a longer DAPT (12 months). Interestingly, the rate of ischemic events was lowered by a longer-term DAPT in the subset of patients aged <65.
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
In patients with ACS, 6-month DAPT was associated with an increase in the MI rate, as compared with a 12-month or longer DAPT duration.
Bivalirudin or Heparin in Patients Undergoing Invasive Management of Acute Coronary Syndromes
Bivalirudin was associated with a reduction in major bleeding (mainly non-access site), but the rate of the 2 prespecified composite coprimary endpoints (MACE and NACE = MACE + major bleeding) remained similar.
Ticagrelor vs Clopidogrel After Fibrinolytic Therapy in Patients With ST-Elevation Myocardial Infarction: A Randomized Clinical Trial
Ticagrelor was shown to be non-inferior to Clopidogrel, in terms of 30-day TIMI major bleeding, in STEMI patients treated with fibrinolytic therapy.
Interventions for valvular disease and heart failure
Long-term mortality in patients with severe secondary mitral regurgitation and normal left ventricular ejection fraction: interventional perspective
Severe secondary MR in patients with normal LVEF was associated with a nearly 20% mortality at one year, which may warrant inclusion of this population in transcatheter MV intervention trials.
Branch Pulmonary Artery Valve Implantation Reduces Pulmonary Regurgitation and Improves Right Ventricular Size/Function in Patients With Large Right Ventricular Outflow Tracts
Percutaneous branch PA valve implantation (unilateral or bilateral) was associated with a reduction in RV volume and a clinical benefit, thus making it a potential treatment strategy for select patients with an indication for percutaneous pulmonary valve intervention, but with a large RVOT.
Conscious Sedation Versus General Anesthesia in Transcatheter Aortic Valve Replacement: The German Aortic Valve Registry
Local anesthesia or conscious sedation in patients treated with TAVR was associated with a lower rate of post-procedural complications and 30-day mortality, over general anesthesia, albeit 1-year mortality rates were similar.
Patent foramen ovale closure vs. medical therapy for cryptogenic stroke: a meta-analysis of randomized controlled trials
In patients with cryptogenic stroke, PFO closure reduced the risk of further stroke over medical therapy alone, particularly in the presence of moderate to large shunts.
Compare and contrast tricuspid and mitral valve anatomy: interventional perspectives for transcatheter tricuspid valve therapies
As the progress of valve interventions continues, reassessment of the valve anatomy may be the key for future developments in technology and technique.
PCR Interventionalists’ corner
Innovations in Radiation Safety During Cardiovascular Catheterization
Learn about the techniques that may be used in you daily practice to enhance the radioprotection, both for you and your patients.