TCT 2011 - Cardiology Conference Coverage

Heartwire

Interventional/Surgery

"Third-generation" Synergy and Cre8 DES show promise

Nov 11, 2011 18:50 EST

Two early-phase trials of novel drug-eluting stents seeking to move beyond permanent polymer coatings have shown that the Synergy and Cre8 devices seem to match market-approved devices, at least in terms of late loss in simple lesions.

Interventional/Surgery

ROTAXUS: No benefit of atherectomy plus DES in calcified lesions

1 COMMENT - Nov 11, 2011 17:00 EST

Although investigators concluded that rotational atherectomy does not increase the efficacy of drug-eluting stents in calcified lesions, they stressed that provisional atherectomy still has a role in patients with complex, calcified lesions and remains a bailout strategy for lesions that cannot be crossed or dilated.

Interventional/Surgery

ADVISE: New pressure measurement does not require adenosine, equals FFR

Nov 11, 2011 16:30 EST

Investigators say the technology should have increased applicability in more patients, especially those who are unable to tolerate adenosine, and can improve work flow in the catheterization lab.

Acute Coronary Syndromes

Zotarolimus stent matches everolimus DES in TWENTE

1 COMMENT - Nov 11, 2011 15:05 EST

This is now the second randomized clinical trial comparing the Resolute zotarolimus-eluting stent with the market-leading Xience V, showing nearly identical rates of target vessel failure at one year.

Interventional/Surgery

Transfemoral, but not transapical TAVR, "economically attractive"

Nov 10, 2011 20:20 EST

An economic analysis of patients with severe aortic stenosis and high surgical risk reveals that transcatheter aortic-valve replacement via the femoral artery is an "economically attractive" option compared with aortic-valve replacement surgery. Transapical TAVR, on the other hand, does not share the same financial upside, say researchers.

Interventional/Surgery

TRIGGER-PCI enlightens: Platelet function not always useful as guide to antiplatelet therapy

2 COMMENTS - Nov 10, 2011 19:00 EST

Does aggressive antiplatelet therapy—for example, with prasugrel instead of clopidogrel—amount to overkill if patients getting PCI are very low risk to start with?

Interventional/Surgery

RIFLE STEACS: Lower risk of MACCE with radial-access PCI in STEMI patients

Nov 10, 2011 18:00 EST

Investigators say the radial-access approach should no longer be considered a valid alternative to the femoral approach but instead should become the recommended access site for STEMI and other ACS. While others agree, they argue that experience is still needed and that unless a clinician is trained and proficient, they shouldn't be doing radial-access PCI in STEMI patients.

Interventional/Surgery

Transcatheter valves at two years: PARTNER B

Nov 10, 2011 17:10 EST

Two-year outcomes in the PARTNER B trial, testing transcatheter aortic-valve replacement against best medical care, show that survival curves are continuing to separate over time.

Interventional/Surgery

STACCATO: Transapical TAVI in surgery-eligible patients stopped due to adverse events

Nov 10, 2011 16:25 EST

A study comparing the transapical approach for transcatheter aortic-valve implantation against conventional aortic-valve replacement surgery was stopped early due to an increase in adverse events, including an increased risk of major stroke and severe paravalvular leakage, in elderly patients eligible for surgery. One surgeon, however, is highly critical of the study results, calling STACCATO a flawed study.

Interventional/Surgery

Four-year LEADERS data: Stent with biodegradable polymer is noninferior to Cypher

Nov 10, 2011 15:25 EST

One of the newer, second-generation DES, the biolimus-eluting stent on a biodegradable-polymer platform, is noninferior to the previously considered gold-standard sirolimus-eluting stent, new four-year data from the LEADERS trial show. This is the first randomized clinical trial to indicate that a newer DES might be better than Cypher, state the authors.

Interventional/Surgery

PARTNER QoL data hint transapical TAVI falls short of aortic-valve surgery

Nov 10, 2011 14:33 EST

Lower QoL scores for patients who underwent a transapical transcatheter valve implantation vs surgical replacement in PARTNER A should prompt a "rethink" of how many TAVI are performed via the transapical route, one investigator says.

Interventional/Surgery

RAPID GENE: Clopidogrel-response gene test makes point-of-care debut

2 COMMENTS - Nov 9, 2011 21:40 EST

A genotyping device "about the size of a toaster" gives a result in one hour, identifying patients with the CYP2C19*2 clopidogrel-resistance allele. But how useful might the device be in clinical practice?

Interventional/Surgery

ADAPT-DES: Platelet tests predict stent thrombosis for populations, not individuals

1 COMMENT - Nov 9, 2011 17:40 EST

Low sensitivity and specificity of platelet-function testing with this assay means that the VerifyNow test is not so helpful at predicting 30-day risk of stent thrombosis at the patient level, although absolute and relative levels of platelet inhibition with stent thrombosis were tracked in this registry.

Interventional/Surgery

Late stent thrombosis occurs up to seven years after first-generation DES implantation

2 COMMENTS - Nov 9, 2011 15:45 EST

Results from a large case-control registry of first-generation drug-eluting stents suggest that patients are not in the clear from stent thrombosis after one year or even after many years after stent implantation.

Acute Coronary Syndromes

BRIDGE to surgery: Cangrelor may safely wean ACS patients off oral antiplatelets

Nov 9, 2011 15:45 EST

Continuous infusion of the P2Y12-receptor inhibitor leveled out platelet activity while ACS patients went off oral dual antiplatelet therapy before CABG in a small phase 2 study.

Interventional/Surgery

Early data from real-world registry shows 98% patients taking DAPT at 30 days: PARIS

1 COMMENT - Nov 9, 2011 15:00 EST

Despite nearly all patients taking dual antiplatelet therapy at 30 days, the researchers observed that nonadherence was associated with significantly higher risk of ischemic events, including a higher risk of stent thrombosis.

Interventional/Surgery

Steeper learning with transradial interventions, but proficiency can be achieved

Nov 8, 2011 16:45 EST

One study showed that transradial cardiac catheterization, including diagnostic angiograms and coronary interventions, was comparable to the femoral approach when performed by operators in training, while another suggested that the learning curve for transradial-access PCI is steeper than first thought.

Interventional/Surgery

Hype or hazard? Longitudinal stent compression hashed out at TCT

Nov 8, 2011 16:30 EST

Experts at a TCT session said that this complication is rare, grabbing undue attention, and in many cases avoidable with meticulous technique, although most agreed that stent design likely plays a factor in making some stents more vulnerable than others.

Interventional/Surgery

Virmani's crystal ball: Transcatheter valves

Nov 7, 2011 17:30 EST

It's early days, but so far valve durability with both the Edwards Sapien and Medtronic CoreValve devices looks remarkably good, with most causes of valve failure similar to those seen with surgical valves.

Discussion and opinions

Blogs

Topol and Teirstein: The Click and Rub Show

#10: What case for live cases?

Nov 14, 2011 09:35 EST

2 comments

Heart failure and transplantation with Dr Ileana Piña

Focus on heart failure at TCT 2011

Nov 10, 2011 15:25 EST

Late-Breaking Clinical Trials and First Report Investigations I
Wednesday, November 9, 11:30 am-1:00 pm
Main Arena I
Moderator: E Magnus Ohman

Download as PDF

Focus on PCI Pharmacology and Stent Thrombosis I
	ADAPT-DES: A Large-Scale, Prospective, Multicenter Registry Examining the Relationship of Platelet Responsiveness and Stent Thrombosis After DES Implantation Gregg Stone MD
	DESERT: A Large-Scale, Case-Controlled, Multicenter Study Examining the Predictors of Stent Thrombosis Ron Waksman MD
	PARIS: A Larger-Scale, Prospective, Multicenter Registry Studying the Patterns of and Reasons for Nonadherence to Antiplatelet Agents in Stented Patients Roxana Mehran MD

Focus on PCI Pharmacology and Stent Thrombosis II

	*RAPID GENE: A Prospective, Randomized Trial of Prasugrel vs Clopidogrel in CYP2C192 Carriers Identified by Rapid Point-of-Care Genotyping** Derek So MD
	TRIGGER-PCI: A Prospective, Randomized Trial of Prasugrel vs Clopidogrel in Clopidogrel-Hyporesponsive Patients with Stable Ischemic Heart Disease Undergoing Percutaneous Coronary Intervention Dietmar Trenk PhD
	BRIDGE: A Prospective, Randomized, Placebo-Controlled, Double-Blind, Multicenter Trial of Intravenous Cangrelor in Patients Awaiting Surgery Dominick Angiolillo MD PhD

Late-Breaking Clinical Trials and First Report Investigations II
Thursday, November 10, 11:15 am-1:00 pm
Main Arena II
Moderator: Patrick O'Gara

Focus on Transcatheter Aortic-Valve Replacement
	PARTNER Cohort B Two-Year: A Prospective, Randomized Trial of Transcatheter Aortic-Valve Replacement vs Standard Therapy in Patients with Inoperable Aortic Stenosis Raj Makkar MD
	PARTNER Cohort A QOL: Quality-of-Life Analysis from a Prospective, Randomized Trial of Transcatheter Aortic-Valve Replacement vs Surgical Aortic-Valve Replacement in High-Surgical-Risk Patients with Aortic Stenosis David Cohen MD
	PARTNER Cohort A CE: Cost-effectiveness Analysis from a Prospective, Randomized Trial of Transcatheter Aortic-Valve Replacement vs Surgical Aortic-Valve Replacement in High-Surgical-Risk Patients with Aortic Stenosis Matthew Reynolds MD
	STACCATO: A Prospective, Randomized Trial of Transapical Transcatheter Aortic-Valve Replacement vs Surgical Aortic-Valve Replacement in Low-Surgical-Risk Elderly Patients with Aortic Stenosis Leif Thuesen MD

Focus on Primary PCI in STEMI
	RIFLE STEACS: A Prospective, Randomized Trial of Radial vs Femoral Vascular Access in Patients with ST-Segment Elevation Myocardial Infarction Enrico Romagnoli MD
	MUSTELA: A Prospective, Randomized Trial of Thrombectomy vs No Thrombectomy in Patients with ST-Segment Elevation Myocardial Infarction and Thrombus-Rich Lesions Anna Sonia Petronio MD
	DEB-AMI: A Prospective, Randomized Trial of Paclitaxel-Coated Balloons plus Bare-Metal Stents vs Paclitaxel-Eluting Stents vs Bare-Metal Stents Alone in Patients with ST-Segment Elevation Myocardial Infarction Pieter Stella MD PhD

Late-Breaking Clinical Trials and First Report Investigations III
Friday, November 11, 11:00 am-1:10 pm
Main Arena III
Moderator: Gregg Stone

Focus on Novel Drug-Eluting Stents and Drug-Coated Balloons
	EVOLVE: A Prospective, Randomized Trial of Two-Dose Formulations of a Bioabsorbable Polymer-Based Everolimus-Eluting Stent vs a Durable Polymer-Based Everolimus-Eluting Stent Ian Meredith MBBS PhD
	REMEDEE: A Prospective, Randomized Trial of a Combination Bioabsorbable Polymer-Based Anti-CD34 Antibody Sirolimus-Eluting Stent vs a Durable Polymer-Based Paclitaxel-Eluting Stent Michel Haude MD
	CRE8: A Prospective, Randomized Trial of a Carbofilm-Coated Stent Eluting Sirolimus from Abluminal Reservoirs vs a Paclitaxel-Eluting Stent Didier Carrié MD PhD
	PEPCAD-DES: A Prospective, Randomized Trial of a Paclitaxel-Coated Balloon vs Uncoated Balloon Angioplasty in Patients with Restenosis of Drug-Eluting Stents Harald Rittger MD

Focus on Optimal PCI
	TWENTE: A Prospective, Randomized Trial of Zotarolimus-Eluting Stents and Everolimus-Eluting Stents in an Unselected Patients with Coronary Artery Disease Clemens von Birgelen MD PhD
	ROTAXUS: A Prospective, Randomized Trial of High-Speed Rotational Atherectomy Prior to Paclitaxel-Eluting Stent Implantation in Complex Calcified Coronary Artery Lesions Gert Richardt MD
	ADVISE: Validation of a Vasodilator-Independent Measure of Coronary Fractional Flow Reserve Justin Davies MD

Focus on Peripheral Vascular Disease
	COBRA: A Prospective, Randomized Trial of Cryoplasty vs Conventional Balloon Post-Dilatation of Nitinol Stents in the Superficial Femoral Artery of Patients with Diabetes Mellitus Subhash Banerjee MD
	PROFI: A Prospective, Randomized Trial of Proximal Balloon Occlusion vs Distal Filter Embolic Protection in Patients Undergoing Carotid Stenting Klaudija Bijuklic MD

TCT 2011 - San Francisco, CA
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Heartwire

Discussion and opinions

Editorial programs

TCT 2011 - San Francisco, CA View all conferences »

Heartwire

Discussion and opinions

Editorial programs

TCT 2011 - San Francisco, CA
View all conferences »