The Biggest News of 2019: TCTMD’s Top 10
A diabetes drug in heart failure, best approaches for stable CAD, a left main trial tempest, and TAVR for low-risk AS led the list.
The blockbuster ISCHEMIA trial, the controversy over EXCEL, dapagliflozin’s big win in heart failure, and the low-risk TAVR trials were among the most-read news on TCTMD this year.
1) ISCHEMIA: Invasive Strategy No Better Than Meds for CV Events
Both the “expanded” endpoint and death/MI were no different between arms, but QoL was significantly better with PCI/CABG.
2) Former EXCEL Investigator Alleges Trial Manipulation, Prompting Vehement Denials
Surgeon David Taggart set the EACTS meeting ablaze when he accused EXCEL researchers of stacking the deck in PCI’s favor.
3) DAPA-HF Details: Dapagliflozin Slashes HF Outcomes, Even in Nondiabetics
Investigators saw benefits with the SGLT2 inhibitor across all subgroups. One observer predicts a new era of heart failure care.
4) Low-Risk Trials Cement a Role for TAVR Alongside—or in Place of—Surgery
Both trials showed TAVR is noninferior to surgery in low-risk patients, but PARTNER 3 beat expectations with a clear win for Sapien 3.
5) FDA Expands TAVR Indication to Low-Risk Patients
Both Evolut R and Evolut PRO, as well Sapien 3, received the expanded indication in the eagerly awaited announcement.
6) AUGUSTUS: Apixaban Plus P2Y12 Inhibitor the Best Combo in A-fib Patients With ACS or Undergoing PCI
Aspirin increased bleeding with no ischemic benefit, but a trend toward more stent thrombosis with placebo warrants further study, researcher says.
7) TWILIGHT: Ticagrelor Monotherapy Lowers Bleeding Without Increasing Ischemic Events
Experts agree the findings suggest that aspirin can be dropped in practice 3 months after PCI in this high-risk patient cohort.
The latest wallop to this fraught field comes in the form of a correction notice showing a higher death rate for DES-treated patients at 5 years.
9) FDA Alerts Doctors to Potential Late Risks With Paclitaxel-Coated Balloons and Stents in PAD
The “Dear Doctor” letter notes that the FDA is following up on a recent meta-analysis pointing to increased mortality and urges close reporting of events.
10) EACTS Pulls Out of Left Main Guidelines After BBC Bombshell Alleging EXCEL Trial Cover-up
The explosive story reports that trialists concealed MI rates favoring CABG according to definitions promised in the trial.
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Shelley Wood is Managing Editor of TCTMD and the Editorial Director at CRF. She did her undergraduate degree at McGill…
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