One of the most contentious questions in interventional cardiology right now is what to do with the patient who has atrial fibrillation and then also needs PCI. The conventional approach has been to give them a period of so-called triple antithrombotic therapy. However, that strategy has now been demonstrated in a number of randomized controlled trials to increase the risk for major bleeding. More surprisingly, there doesn’t seem to be any detectable benefit to a strategy of triple therapy vs. double antithrombotic therapy for ischemic or thromboembolic endpoints in these patients. Nevertheless, despite my own impressions, there are many different ways of looking at the data and, in this issue, we interview a variety of experts to see how they view the topic. Read more in the Cover Story.
Also in this issue is an update on developments in carotid stenting. In particular, embolic protection devices continue to undergo refinement. Having been involved with carotid stenting before and after the availability of embolic protection devices, it continues to fascinate me how this field has evolved.
Much like how transradial access has revolutionized coronary intervention, this issue also explores how transpedal and tibial access are transforming peripheral intervention. I think in the future, these alternative modes of vascular access will become even more popular.
On pages 24 and 26, we cover important presentations from the annual EuroPCR and Society for Cardiovascular Angiography and Interventions meetings. Hopefully, these meeting summaries provide those of you who were unable to attend the meetings a chance to share the excitement.
Finally, in the Clinical News section, you’ll find new data on the contentious topic of public reporting of PCI outcomes. This provides a good lesson in potential unintended consequences.
As you can see, there is diverse coverage of topics pertaining to coronary and endovascular intervention. We welcome your feedback. Let us know what other hot topics you are interested in reading about in Cardiology Today’s Intervention by emailing the Editors at firstname.lastname@example.org.
– Deepak L. Bhatt, MD, MPH
Chief Medical Editor
Cardiology Today’s Intervention