January 18, 2020
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Top intervention news of 2019: ISCHEMIA trials, low-risk TAVR, paclitaxel debate and more

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Healio and Cardiology Today compiled a list of the most-read cardiac and vascular intervention articles published in 2019.

Readers were interested in results of trials including ISCHEMIA, AUGUSTUS, COMPLETE and ISAR-REACT 5, continued debate on the use of paclitaxel-coated products for the treatment of peripheral artery disease, and TAVR in low-risk patients. Read the top articles from 2019, in no particular order, below.

 

ISCHEMIA: Invasive strategy, medical therapy yield similar CV outcomes in stable ischemia

In stable patients with moderate or severe ischemia, an invasive strategy and a conservative strategy of optimal medical therapy yielded similar long-term CV outcomes, according to long-anticipated results of the ISCHEMIA and ISCHEMIA-CKD trials presented at the American Heart Association Scientific Sessions. Read more

 

At Issue: ISCHEMIA trials provoke debate on treatment of stable ischemic heart disease

Results from the ISCHEMIA and ISCHEMIA-CKD trials of invasive vs. conservative strategies in patients with stable ischemic heart disease were the biggest news to come out of the American Heart Association Scientific Sessions, with some observers saying they were the most important trials in stable ischemic heart disease in more than a decade. Healio spoke with experts about their reactions to the new data and what the future might hold. Read more

 

FDA advises clinicians to discuss risks of paclitaxel-coated devices with patients

The FDA issued a series of recommendations following an advisory panel meeting on a signal of late mortality risk associated with paclitaxel-coated devices to treat peripheral artery disease, including advising clinicians to discuss extensively with patients the risks and benefits of the devices and to ensure patients are on optimal medical therapy and are following appropriate lifestyle practices. Read more

 

A New Era for TAVR

Presentation of the PARTNER 3 and Evolut Low Risk trials at the American College of Cardiology Scientific Session in March 2019 was met with a standing ovation and applause, high praise from legends in the field and the overwhelming sense that transcatheter aortic valve replacement may soon replace surgical AVR as the treatment of choice for patients with symptomatic severe aortic stenosis. Read more

 

TWILIGHT: Switching to ticagrelor monotherapy 3 months post-PCI lowers bleeding vs. DAPT

Among patients who underwent PCI with a drug-eluting stent and were prescribed dual antiplatelet therapy for 3 months, subsequent ticagrelor monotherapy lowered bleeding risk without raising ischemic risk compared with continued DAPT, according to results of the TWILIGHT trial presented at TCT 2019. Read more

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ISAR-REACT 5: Prasugrel superior to ticagrelor in patients with ACS, planned invasive evaluation

In patients with acute coronary syndromes, with or without ST-segment elevation, the rate of death, MI or stroke was significantly reduced at 1 year with prasugrel compared with ticagrelor, without an increase in major bleeding, according to a head-to-head comparison of both strategies. Read more

 

AUGUSTUS: Dual therapy with apixaban, P2Y12 inhibitor safe in Afib patients post-ACS or PCI

New data from the AUGUSTUS trial provide insight on the appropriate antithrombotic regimen after ACS or PCI in patients with atrial fibrillation. Read more

 

GALILEO: Rivaroxaban raises death, thrombotic, bleeding risk vs. antiplatelet therapy after TAVR

Among patients who underwent successful transcatheter aortic valve replacement and were not on chronic oral anticoagulation, rivaroxaban was linked to higher risk for death/thromboembolic complications and bleeding compared with antiplatelet therapy, according to results from the GALILEO trial. Read more

 

Role of atherectomy in endovascular interventions up for debate

Atherectomy appears to have its place in practice, but experts remain somewhat divided over how judiciously the procedure should be used in endovascular interventions. Read more

 

PFO closure re-emerging

Because the benefits of patent foramen ovale closure were once in question, physicians remain hesitant about its use in clinical practice. Recent data, however, have confirmed the safety and efficacy of PFO closure for secondary stroke prevention and experts are now encouraging their colleagues to consider PFO closure in certain patients. Read more

 

Complete revascularization superior to culprit lesion-only PCI for STEMI, multivessel CAD: COMPLETE

Complete revascularization was superior to culprit lesion-only PCI for reducing risk for CV death or MI in patients with STEMI and multivessel CAD. Read more

 

New advances offer hope to patients with CLI

While critical limb ischemia presents many challenges, numerous new technologies and techniques are being developed to help this population. Read more

 

FRANCE-TAVI: In retrospective study, balloon-expandable TAVR valves safer than self-expanding

Balloon-expandable transcatheter aortic valves were associated with less paravalvular regurgitation and mortality compared with self-expanding valves, according to the FRANCE-TAVI retrospective study presented at the American Heart Association Scientific Sessions. Read more

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