Polymer-free amphilimus-eluting stents (PF-AES) are non-inferior to permanent-polymer zotarolimus-eluting stents (PP-ZES) in terms of target-lesion failure at 12 months, according to the results of the ReCre8 study, presented by Pieter R. Stella, MD, Ph.D. (University Medical Center, Utrecht, the Netherlands) at TCT 2018. The results for the first RCT comparing PF-AES versus latest generation PP ZES in an all-comers PCI population were simultaneously published in Circulation. Continue reading →

Findings from the SORT-OUT trial, presented at the 30^th annual Transcatheter Cardiovascular Therapeutics (TCT) conference 2018 held at San Diego, showed that at 12 months, polymer free Biolimus A9-coated BioFreedom stent was non-inferior to the thin strut, biodegradable polymer cobalt-chromium sirolimus-eluting Orsiro stent in an all-comers patient population. Continue reading →

A recent meta-analysis published in the Journal of American College of Cardiology has shown that early discharge (ED) after uncomplicated Transaortic valve replacement (TAVR) is safe and has no negative impact on discharge to 30-day mortality or the need for permanent pacemaker insertion (PPI). Continue reading →

Findings from an international TAVR registry involving 16 centers and spanning over a decade have important implications for operator training and patient care at centers performing TAVR. The study, published in JACC Cardiovascular Interventions, is a testament to the learning curve that still exists with both greater procedural safety and lower mortality rates reported when TAVR is performed by experienced operators. Additionally, TAVR performed at low annual volume (<50 procedures) institutions is associated with decreased procedural safety and higher patient mortality. This stepwise improvement in patient outcomes bears important implications for operator training and patient care at centers performing TAVR. Continue reading →

Researchers have confirmed that the extent of residual angiographic disease calculated using the residual SYNTAX score (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) or RSS has no association with ischemic events occurring subsequently in patients presenting with ACS. The study, published in JACC, reinforces the concept that functionally complete revascularization is applicable even in ACS patients. Continue reading →

Results of the BIOSCIENCE study that were presented at the ESC Annual Congress by Dr. Thomas Pilgrim, University Clinic for Cardiology, Bern, Switzerland, show that the 5-year risk of target lesion failure among patients undergoing percutaneous coronary intervention (PCI) is similar after implantation of the ultrathin-strut, biodegradable-polymer sirolimus-eluting stents as compared with thin-strut, durable-polymer, everolimus-eluting stents. However, higher incidence of all-cause and non-cardiovascular mortality in patients treated with the biodegradable polymer sirolimus-eluting-stents as compared with the durable-polymer stents eluting everolimus warrant careful scrutiny in ongoing clinical trials. The announcement of the results of this trial at the ESC was accompanied by a publication in the Lancet. Continue reading →

 In a randomized multi-center clinical trial that enrolled more than 700 patients with multi-vessel coronary artery disease and acute myocardial infarction (MI) with cardiogenic shock, it was shown that percutaneous coronary intervention (PCI) of the culprit lesion only (with the option of staged revascularization of nonculprit lesions) was associated with better clinical outcomes compared to immediate multi-vessel PCI. It was found that at 30 days, there was a 9.5% absolute reduction in the rate of the primary endpoint of death or renal replacement therapy in patients randomized to culprit-lesion only revascularization. Previously DANAMI-3-PRIMULTI, PRAMI, and CvLPRIT trials have suggested that there may be a benefit to complete revascularization but those studies did not enroll patients with hemodynamic instability or cardiogenic shock. Consequently, this led to the inclusion of immediate multi-vessel PCI in the 2015 ACC/AHA/SCAI STEMI guidelines as a Class II-b recommendation (can be considered). Continue reading →

A new single-center study has shown that the catheterization laboratory (CCL) activation in response to a prehospital ECG interpreted as ST-segment elevation myocardial infarction (STEMI) can be frequently canceled which represents an economic burden and affects the patient satisfaction negatively. Continue reading →

The 1-year results of a phase 2, sham-controlled RCT have confirmed the safety of a transcatheter interatrial shunt device (IASD; Corvia Medical) with no significant cardiovascular or renal events as compared to those receiving sham control treatment. It has also confirmed the long-term patency of the device. The findings were presented at the ESC and have also been simultaneously published in JAMA Cardiology. Continue reading →

Spontaneous coronary artery dissection (SCAD) is an underdiagnosed, poorly misunderstood condition. The predisposing causes and management of this condition are still unclear. To throw light on this, the CANADIAN SCAD cohort study was a large, prospective, multicenter, observational, natural history study that enrolled 750 non-atherosclerotic SCAD patients from 22 centers (20 from Canada and 2 from the US). The key study objective was the analysis of cardiovascular outcomes within the hospital and long-term. Secondary outcomes included the assessment of clinical and angiographic characteristics of patients presenting with SCAD. Continue reading →

In the final follow up of the FAME 2 study,  published in The New England Journal of Medicine, five year outcomes were reported comparing percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) to medical therapy alone. The hypothesis had suggested FFR guided PCI would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. Continue reading →

In a recent study published in the Journal of the American College of Cardiology (JACC), it was found that patients undergoing uncomplicated TAVR have a safe next-day discharge (NDD) profile with no difference in 30-day mortality rate in comparison to an increased length of hospital stay. In addition, the study also highlighted better 1-year clinical outcomes in patients as compared to non-NDD group. Continue reading →

“The variation in cholesterol levels is associated with an increase in the percentage of atheroma volume and worse clinical outcomes,” says a new meta-analysis in the European Heart Journal. Continue reading →

A recent study published in the Journal of American College of Cardiology found that implantation of the coronary sinus Reducer is safe and is associated with a reduction of anginal symptoms and improvement of quality of life in patients with refractory angina who were not candidates for further revascularization. Continue reading →

Dr. Naidu, Dr. Brikalis, and Dr. C. Michael Gibson Discuss

Podcast: Download

Dr. Kirk Garratt, Dr. Ajay Kirtane and Dr. C. Michael Gibson Discuss

Podcast: Download

A non-randomized study published in the American Heart Journal showed increased survival rates in patients with Impella device being used as the first support strategy for patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) when invasive hemodynamic monitoring was used, and at centers with higher Impella implantation volume. Continue reading →

In a recent study published in the Journal of the American College of Cardiology, the implementation of Transcatheter Aortic Valve Replacement (TAVR) was investigated in France.

Continue reading →