Providing a snapshot of the year in interventional cardiology, the most popular news stories that appeared on TCTMD in 2009 were dominated by stenting, adjunctive pharmacology, and new devices, ranging from safety trials with drug-eluting stents to triple antithrombotic therapy to drug-eluting balloons. Below are the 10 most-read stories from the past year in descending order. Sadly, the most popular story was for the death of distinguished interventionalist and thought leader Donald S. Baim, MD:
1. Renowned Interventionalist Donald Baim Dies at Age 60
Donald S. Baim, MD, a clinician, researcher, and innovator who was at the forefront of the development of percutaneous coronary intervention (PCI), died November 6, 2009, following surgery for adrenal cancer. He was 60 years old. (Read more…)
2. From JACC: Late Safety of DES Undercut by Taxus
Patients treated with paclitaxel-eluting stents are at increased risk of stent thrombosis and myocardial infarction compared with those who receive either bare-metal or sirolimus-eluting stents, according to long-term follow-up of a large registry study published in the February 24, 2009, issue of the Journal of the American College of Cardiology. Moreover, they face higher mortality just 1 year after implantation. (Read more…)
3. From JACC: CV Interventions: Two Stents Better Than One for Coronary Bifurcation Lesions
For most patients receiving drug-eluting stents for coronary bifurcation disease, the alternative strategies of mini-crush stenting with 2 stents or provisional T stenting provide comparable procedural success with low complication rates and a similar incidence of longer-term major adverse cardiac events. However, the initial 2-stent approach yields a lower rate of angiographic restenosis in both the main and side branches, according to a paper published in the March 2009 issue of JACC: Cardiovascular Interventions. (Read more…)
4. From TCT 2009: Doubling Up on Clopidogrel Dose Reduces MI, ST
SAN FRANCISCO, Calif.—Double-dose clopidogrel reduced stent thrombosis and MI rates among patients undergoing PCI for STEMI, regardless of whether patients received drug-eluting or bare-metal stents, according to CURRENT-STEMI PCI trial results. (Read more…)
5. From TCT 2009: HORIZONS AMI: Triple Antithrombotic Therapy Elevates Stroke, Bleeding Risk
SAN FRANCISCO, Calif.—One-year rates of stroke, bleeding, and net adverse clinical events for patients with STEMI receiving triple antithrombotic therapy were significantly increased compared with patients receiving dual antiplatelet therapy, according to findings from the HORIZONS AMI trial. (Read more…)
6. From TCT 2009: PROSPECT Assesses Impact of Non-Culprit Lesions
SAN FRANCISCO, Calif.—In ACS patients treated with stents and medical therapy, culprit and non-culprit lesions contribute equally to the risk of 3-year adverse events. Identification of lesions can be enhanced by intravascular ultrasound and virtual histology, according to the first prospective natural history study of atherosclerosis using multimodality imaging to characterize the coronary tree. (Read more…)
7. From EuroPCR 2009: Results Deflate Hopes for Paclitaxel Balloon
BARCELONA, Spain—Despite previous encouraging results, a clinical trial evaluating a new paclitaxel-eluting balloon was halted early when interim findings showed no improvements in percent diameter stenosis over Taxus stents in treating small coronary vessels, according to late-breaking trial results presented May 21 at EuroPCR 2009. In fact, several angiographic endpoints were worse with the balloon. (Read more…)
8. Feature Article: Percutaneous Aortic Valve Replacement: A New Technology Defines Its Role
Recent landmarks serve to punctuate the fast-moving field of percutaneous aortic valve implantation. For instance, in May 2009, Medtronic announced the 4,000th placement of its CoreValve aortic prosthetic valve, only 2 years after the device’s European approval (CE mark). Meanwhile, Edwards Lifesciences estimates that more than 2,500 of the company’s valves, the only other approved device (also CE mark), have been implanted in clinical trials worldwide, and enrollment in its pivotal randomized trial will be complete soon. (Read more…)
9. From AHA 2009: Drug-Eluting Balloons Lose Steam in Latest Study
ORLANDO, FL—Despite their intriguing technology, drug-eluting balloons continue to produce mixed results. In the latest study, a system combining a paclitaxel-eluting balloon with a bare-metal stent did not reach noninferiority against a sirolimus-eluting stent in treating de novo coronary lesions and actually showed worse safety outcomes, according to data presented November 14 at the American Heart Association Scientific Sessions 2009. (Read more…)
10. From CMAJ: Proton Pump Inhibitor-Clopidogrel Interaction Increases Reinfarction Risk
In patients receiving clopidogrel following an acute myocardial infarction, the addition of a proton pump inhibitor (PPI)—other than pantoprazole—increases the risk of reinfarction, according to a study published online January 28, 2009, ahead of print in the Canadian Medical Association Journal. Previous research suggested that most PPIs interfere with the metabolism of clopidogrel, thereby blunting its antiplatelet effect. (Read more…)
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