Drug-Eluting Stents Fare Better Than Bare-Metal Stents in Patients With High Bleeding Risk Efficacy and Safety of Drug-Eluting Stents Optimized for Biocompatibility vs Bare-Metal Stents With a Single Month of Dual Antiplatelet Therapy: A Meta-analysis

A meta-analysis conducted by Shah and his colleagues published in JAMA cardiology demonstrated that in patients with high bleeding risk, coronary interventions with drug-eluting stents (DES) optimized for biocompatibility were preferable over those with bare-metal stents (BMS) in terms of both safety and efficacy, in patients with only 1 month of Dual Antiplatelet therapy (DAPT). Continue reading

Emergency Department Chest Pain Volume Impacts Patient Outcomes Emergency Department Volume and Outcomes for Patients After Chest Pain Assessment

A study published in Circulation showed that the evaluation of chest pain in emergency departments with higher chest pain volume had lower rates of death or hospitalization for patients with acute coronary syndrome after discharge. The primary investigator, Dr. Dennis T. Ko and his colleagues also found that past a certain volume threshold, a rise in volume was not associated with any reduction in outcomes. Continue reading

Bariatric Surgery in Severe Obese Diabetics Associated with Lower Risk of Macrovascular Outcomes Association Between Bariatric Surgery and Macrovascular Disease Outcomes in Patients With Type 2 Diabetes and Severe Obesity

A retrospective cohort study performed by David P. Fisher and his colleagues was published in JAMA, showing that bariatric surgery in obese patients with diabetes was associated with a lower incidence of macrovascular events. Continue reading

Assessment of Genomic MetaGRS Scoring System in Prediction of Coronary Artery Disease Genomic Risk Prediction of Coronary Artery Disease in 480,000 Adults

A study published by Journal of the American College of Cardiology described a genomic score having the potential to stratify the risk of coronary artery disease (CAD) and emphasized the possible use of genomic screening in early life, adding to traditional risk factors. Continue reading

Worse Clinical Outcomes of Atrial Fibrillation in Patients with HFpEF Compared to HFrEF Prognostic implications of atrial fibrillation in heart failure with reduced, mid-range, and preserved ejection fraction: a report from 14 964 patients in the European Society of Cardiology Heart Failure Long-Term Registry

A multinational prospective cohort study performed by Barak Zafrir et al. and published in the European Heart Journal concluded that worse cardiovascular outcomes of atrial fibrillation (AF) were associated with heart failure with preserved ejection fraction (HFpEF) and heart failure with middle range ejection fraction (HFmrEF) but not associated with heart failure with reduced ejection fraction (HFrEF). Continue reading

CoQ10 supplementation: A Remedy for Statin‐Induced Myopathy? Effects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials

A meta‐analysis performed by Choi et al., the results of which were published in the Journal of the American Heart Association, indicated that CoQ10 supplementation improved statin‐associated muscle symptoms, suggesting a therapeutic approach for statin‐induced myopathy. Continue reading

Atrial Fibrillation in a Cancer Setting: Understanding Unmet Needs in Cardio-Oncology Provider Specialty, Anticoagulation, and Stroke Risk in Patients With Atrial Fibrillation and Cancer

A new study by Neal et al. demonstrated that although patients with atrial fibrillation (AF) and cancer were less likely to see a cardiologist or fill anticoagulant prescriptions, cardiology involvement was associated with increased anticoagulant prescription fills and favorable AF-related outcomes. The results of the study were published online in JACC. Continue reading

From Barbershops to Churches: Are Community-Based Interventions the Best Way to Engage Vulnerable Populations? Cluster Randomized Clinical Trial of FAITH (Faith-Based Approaches in the Treatment of Hypertension) in Blacks

The FAITH study (Faith-Based Approaches in the Treatment of Hypertension) has portrayed how a community-based lifestyle intervention delivered in churches can lead to a significantly greater reduction in systolic BP in hypertensive blacks in comparison with Health Education (HE) alone. The results were published online in Circulation. Continue reading

Variability in Metabolic Parameters: A Prognostic Surrogate Marker for MI, Stroke and Death? Associations of Variability in Blood Pressure, Glucose and Cholesterol Concentrations, and Body Mass Index With Mortality and Cardiovascular Outcomes in the General Population

A study by Mee Kyoung Kim and her colleagues published in Circulation has shown that there is a graded association between the number of high variability parameters like fasting blood glucose and total cholesterol levels, systolic blood pressure, and body mass index and cardiovascular outcomes. They showed that the mentioned variables may be considered as independent predictors of mortality and cardiovascular events. Continue reading

GLP-1 Receptor Agonist Albiglutide Demonstrates ‘Harmonious’ Cardiovascular Outcomes in Type 2 Diabetics Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease : The HARMONY OUTCOMES trial

The results of the recently published Harmony-Outcomes study in The Lancet, led by Professor Stefano Del Prato, University of Pisa, Italy and Professor John McMurray, University of Glasgow, UK, have demonstrated that among patients with concomitant type 2 diabetes and cardiovascular disease, albiglutide, a glucagon-like peptide 1 receptor agonist is superior to placebo in the reduction of major adverse cardiovascular events. The study suggests that evidence-based glucagon-like peptide 1 receptor agonists should be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Continue reading

Anticoagulant and Antiplatelet Therapy in Stented Patients with Atrial Fibrillation Combining Oral Anticoagulants With Platelet Inhibitors in Patients With Atrial Fibrillation and Coronary Disease

In an article published in the Journal of the American College of Cardiology, authored by Caroline Sindet-Pederson, MSc, and colleagues in the Department of Cardiology at Copenhagen University Hospital Herlev and Gentofte in Hellerup, Denmark, evaluating a real-world population of AF patients with MI and/or after PCI, the use of direct oral anticoagulants (DOAC) as compared to VKA reduced the risk of bleeding in patients also taking dual antiplatelet therapy (DAPT). Continue reading

Periprocedural loading dose of Atorvastatin reduces MACE in patients with ACS undergoing PCI: Is this a Pleiotropic effect? Timing of Loading Dose of Atorvastatin in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes: Insights From the SECURE-PCI Randomized Clinical Trial

A study by Lopes and his colleagues published in JAMA Cardiology has shown that in patients with ACS undergoing PCI, periprocedural loading doses of atorvastatin appeared to reduce the rate of Major Adverse Cardiovascular Events (MACE) at 30 days, primarily in patients with ST-segment elevation myocardial infarction. Insights from the Statins Evaluation in Coronary Procedures and Revascularization (SECURE-PCI) randomized clinical trial showcased this beneficial effect to be preserved and consistent, regardless of the timing of atorvastatin administration, including within 2 hours before PCI. Continue reading

Same Day Discharge Following Elective PCI Proven Both Safe and Economical Association of Same-Day Discharge After Elective Percutaneous Coronary Intervention in the United States With Costs and Outcomes

An observational cross-sectional cohort study by Amin et al. suggested that greater and more consistent use of same-day discharge(SDD) following elective percutaneous coronary intervention (PCI) is the United States, could markedly increase the overall value of PCI care. Apparently, SDD was not only safe but associated with large savings of more than $5000 per PCI. Continue reading

Midterm Survival Rates High in Asymptomatic Aortic Stenosis, Early Intervention Useful in Severe Cases Outcomes of Patients With Asymptomatic Aortic Stenosis Followed Up in Heart Valve Clinics

A study by published in JAMA cardiology indicated that the potential benefit of early intervention must be considered in high-risk AS patients. Cases of asymptomatic AS followed up in heart valve centers had a good midterm survival rate. However, patients with severe AS at baseline and peak aortic jet velocity of 5.0 m/s or greater or LVEF less than 60% had increased risks of all-cause and cardiovascular mortality even after AVR, according to Patrizio Lancellotti, M.D., Ph.D., of University of Liège Hospital in Belgium, and colleagues. The investigators also identified certain factors that correlated with poorer prognosis. Continue reading

Portico TAVR study demonstrates low rates of stroke, death at 1 year One-Year Outcomes with a Self-Expanding, Repositionable Transcatheter Heart Valve in Severe Aortic Stenosis Patients: PORTICO-I

Results from the Portico 1 study were presented during a late-breaking session at the Transcatheter Cardiovascular Therapeutics conference in San Diego showing that transcatheter aortic valve replacement (TAVR) with the new transcatheter heart valve (THV) in patients at increased surgical risk is associated with low 1-year mortality and stroke rates. In the study, favorable hemodynamic results at 1 year were observed with low transvalvular pressure gradient and incidence of significant Paravalvular leakage (PVL).   The results were also published online in the Journal of American College of Cardiology. Continue reading

Pulmonary Artery Denervation Improves Pulmonary HTN in Heart Failure Pulmonary Artery Denervation Significantly Increases 6-minute Walk Distance for Patients with Combined Pre- and Post-capillary Pulmonary Hypertension Associated with the Left Heart Failure: PADN-5 Study

The findings of the Pulmonary artery denervation (PADN) trial, presented at the TCT conference on Sept 23rd have shown that PADN is associated with significant improvements in hemodynamic and clinical outcomes including 6-minute walk distance (6MWD) and pulmonary vascular resistance (PVR) in patients with combined pre- and post-capillary pulmonary hypertension CpcPH. The results of this study were simultaneously published in JACC: Interventions. Continue reading

Highlights of TCT 2018

The results of many interesting trials were presented at the TCT conference 2018 held in San Diego, California. Continue reading

Tiered Approach for Management of Angina Patients With No Obstructive CAD Shows Benefit TCT 2018: Stratified Medical Therapy Using Invasive Coronary Function Testing In Angina, CorMicA Trial

For angina patients without obstructive coronary artery disease (CAD), adjunctive testing of coronary vascular function during coronary angiography followed by medical therapy targeted to the findings improved angina outcomes, according to the CorMicA trial. In the study published in the Journal of the American College of Cardiology, a tiered approach for assessment for microvascular and/or vasospastic angina among patients with stable angina and no evidence of significant epicardial disease was deemed superior to usual care. Continue reading

‘Rota Regret’ Makes Training in High-Speed Rotablation A Necessity, for Interventionalists Dealing with Heavily Calcified Coronary Lesions High-Speed Rotational Atherectomy Versus Modified Balloons Before Drug-Eluting Stent Implantation in Severely Calcified Coronary Lesions: The Randomized PREPARE-CALC Trial. 

The results of PREPARE-CALC trial, presented at TCT 2018, have shown that among patients with severely calcified coronary lesions, the routine use of upfront high-speed rotational atherectomy (RA) increases stent deliverability compared with the use of balloon modification techniques such as scoring or cutting balloons (MB), with similar rates of angiographic late lumen loss and other clinical outcomes at 9 months. In his presentation in San Diego, the author, Dr. Gert Richardt emphasized that a strategy of provisional MB remained feasible, safe, and effective as long as bailout RA was readily available and offered the advantages of compatibility with smaller sized catheters and less irradiation. Continue reading

Encouraging Outcomes in ABSORB IV Pave the Way for Polymeric Coronary Bioresorbable Vascular Scaffolds Blinded outcomes and angina assessment of coronary bioresorbable scaffolds: 30-day and 1-year results from the ABSORB IV randomised trial

In the long saga of ABSORB trials, the ABSORB IV trial presented at the TCT conference 2018 showed that polymeric coronary bioresorbable vascular scaffolds (BVS) were non-inferior to cobalt-chromium-based Xience DES for cardiovascular outcomes of target lesion failure and angina in fairly simple lesion types, with lower acute procedural success in a 1 year period. The results for this trial were published today in The Lancet. Continue reading