The Biggest News of 2018: TCTMD’s Top 10
The most-read news on TCTMD this year included the new cholesterol guidelines, the MitraClip trials, several halted trials, and big meeting news.
The biggest stories on TCTMD this year often—but not always—stemmed from big cardiology meetings. Two MitraClip trials, COAPT from TCT 2018 and MITRA-FR from the 2018 European Society of Cardiology (ESC) Congress, were both in the top three. Also in 2018, cholesterol guidelines from the American Heart Association meeting, an apixaban analysis from the American College of Cardiology conference, ORBITA revelations at the Society for Cardiovascular Angiography and Interventions (SCAI) Scientific Sessions, and the ASCEND trial from ESC made the list. Breaking news also proved popular, including the US Food and Drug Administration approval of andexanet alfa, the halting of GALILEO, and the stoppage of two drug-coated balloon trials in PAD.
1. COAPT: MitraClip Reduces Repeat Hospitalizations, Mortality in Functional MR Patients With Severe HF
Physicians responded with shock and excitement to findings, but struggled to reconcile the results with the MITRA-FR trial.
2. Andexanet Alfa, First Reversal Agent for Factor Xa Inhibitors, Finally Gains FDA Approval
The agent is the second antidote approved for the NOACs, joining idarucizumab, dabigatran’s reversal agent.
3. MITRA-FR: No Benefit of MitraClip in Functional MR
Presenting the results, Jean-François Obadia expressed hope that other trials will help identify patients who might benefit from the device.
4. New Cholesterol Guidelines Make Room for Non-Statin Therapy and CAC Screening
While the guidelines don’t recommend a specific target for treatment, they do suggest additional therapy in high-risk patients with LDL cholesterol 70 mg/dL or higher.
5. GALILEO Trial of Rivaroxaban After TAVR Stopped Early for Harm
Rivaroxaban-treated patients had increased risks of all-cause mortality, thromboembolic events, and bleeding versus those on antiplatelet therapy.
6. Apixaban Has Edge Over Other NOACs in Large, Real-World Analysis
The findings jibe with prior observational studies, but head-to-head trials—however unlikely—would provide the best answers, experts say.
7. ORBITA Continues to Surprise: 85% of Sham Arm Opted for PCI When Trial Ended
A discussion at SCAI tackled lingering ORBITA issues, with experts finally grasping a detail the PI says she’s been emphasizing from the outset.
8. Time for Guidelines to Recommend ARBs Over ACE Inhibitors?
The long-running dispute as to the supremacy of these two drug classes should be put to bed once and for all, say the authors of a new review.
9. ASCEND: Aspirin Doesn’t Look Good for Primary CV Prevention in Diabetic Patients
Given the bleeding seen in the study, US guidelines that have been open to using aspirin in this setting need to be revisited, one expert says.
10. Two Trials Halted in Wake of Study Linking Paclitaxel-Coated Devices to Deaths in PAD
A special meeting will be held in the coming months to review the issue. The lead author says he’s pleased endovascular specialists are taking it seriously.
Top 10 Feature Stories
#CardiologyToo? Sexual Harassment Also Infects Hospital Corridors and the Cath Lab
Calling It Quits: Cath Lab Pioneers Grapple With When to Go and What Comes Next
The M Word: Is Routine Transfemoral PCI Defensible in 2018?
ISCHEMIA Fracas: Amid Charges of Moving the Goalposts, Investigators Come Out Swinging
To RCT or Not to RCT? Impella Debate Pivots on How Best to Study Patients on the Brink of Death
Keeping Up With Cardiology: Old-School Learning Versus the Twittersphere
The Price of Knowledge: Industry-Sponsored Studies in the Era of Evidence-Based Medicine
Bruises and Bumps: How Cardiology Meetings Survived the End of Direct Industry Sponsorship in Europe
Cardiologists Treating Syrian Refugees Call Missions an ‘Addictive’ Passion That Saves Lives
Shelley Wood is Managing Editor of TCTMD and the Editorial Director at CRF. She did her undergraduate degree at McGill…
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