The Biggest News of 2021: TCTMD’s Top 10

Once again our most popular list was dominated by COVID-19, especially signals of CV risk associated with vaccination.

The Biggest News of 2021: TCTMD’s Top 10

Run-of-the-mill research and regulatory news in cardiovascular medicine scarcely made TCTMD’s top 10 list this year: intravascular lithotripsy’s approval, the FAME 3 results, and new inclisiran data were the sole exceptions. Otherwise our most popular stories of 2021 were dominated by COVID-19 and especially the risks—proven and unproven—of cardiovascular side effects with vaccination. Our regularly updated COVID-19 Dispatch, notably, held onto one of the top spots. Stories on sexual harassment policies, crude language in the cath lab, and the link between bad habits and atherosclerotic cardiovascular disease (ASCVD) round out the list.

1. Questions Raised About Study Linking mRNA Vaccines to Increased ACS Risk

In November, an “expression of concern” was attached to an abstract from the American Heart Association meeting, originally published in Circulation, but not before it was seized upon by vaccine skeptics.

SEE ALSO: On December 21, 2021, Circulation posted a correction detailing the limitations of the study

2. Smoking, Drinking, and Drugs—All Signs Point to Earlier ASCVD

In what might have been a sign that people were googling some of their bad habits amid a global pandemic, our second-most-popular story looked at a study showing that people who use four or more recreational drugs face nearly a ninefold higher risk of premature ASCVD.

3. COVID-19: TCTMD’s Dispatch

We launched our daily COVID-19 Dispatch in March of 2020 to keep readers abreast of breaking research and policy news. In mid-2021 we decided (optimistically) to pull back slightly, updating it three times per week. The Dispatch has remained one of our most popular content pieces

4. Blood Clots After COVID-19 Vaccination Linked to Immune Response: UK Report

A range of case reports first raised concerns about the link between acute thrombocytopenia and thrombosis with the AstraZeneca/Oxford vaccine—a signal subsequently reported with the Johnson & Johnson jab. This was one of the first papers seeking to identify the mechanism.

5. Myocarditis in Young People After mRNA COVID-19 Vaccination Higher Than Expected

The other cardiovascular concern to dog the COVID-19 vaccine rollout worldwide was the uptick in myocarditis and pericarditis, particularly in younger males following their second shot. This story stemmed from a meeting of the US Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee. Throughout the year, as our coverage makes clear, experts consistently concluded that the adverse events are rare and typically benign, and that the benefits far outweigh risks.

SEE ALSO: A range of studies later offered additional details, including this one.

6. $45 Million OHSU Lawsuit Hits a Nerve for #CardiologyToo

The dollar figure in a $45 million lawsuit brought against Oregon Health & Science University (OHSU) by a former anesthesia resident made waves in the medical world, but the case also made clear the fact that policies for sexual harassment reporting don’t always work as planned.

7. FDA Approves Shockwave Intravascular Lithotripsy for Calcified Coronaries

Regulatory clearance of this technology was widely anticipated and celebrated—as a lead investigator for the pivotal trial told TCTMD, the simplicity, safety, and efficacy of the device make the choice to use it a no-brainer. What did raise eyebrows, however, was the cost.

8. Crude Awakening: Should Interventional Cardiology Come Clean on Dirty Talk?

“Deep-throat” a catheter, inflate a balloon to “manly pressures,” “violate” an artery, or refer a patient for a “blow job”: off-color slang and sexual innuendo are still heard in the cath lab. Most interventionalists agree it’s time for these terms to go.

9. Big Drops in LDL Cholesterol With Inclisiran, but US Clinicians Still Await Drug’s Approval

Back in March, a pooled analysis of clinical trials testing inclisiran (Leqvio; Novartis) confirmed the agent could reduce LDL levels by more than 50%. At the time, the small interfering RNA (siRNA) molecule had been approved in Europe. FDA approval finally came in the last month of the year.

10. FAME 3: PCI Fails to Demonstrate Noninferiority to Surgery in Three-Vessel CAD

The only clinical trial to make our top 10 list in 2021, this head-to-head comparison showed that PCI guided by a functional assessment of ischemia using fractional flow reserve (FFR) failed to match CABG surgery for the reduction of major adverse cardiovascular and cerebrovascular events.

SEE ALSO: One of our Glancing Back, Looking Forward feature stories explores whether the FAME 3 results, on top of several other negative trials, mean it’s time to back off on FFR.

Top Feature Stories, 2021

1. Low Numbers and ‘Anecdata’: Shoddy Research Rode COVID-19’s First Wave

2. Four Pillars, Fast? Rapid Sequencing of HF Drugs Faces an Uphill Battle

3. When the Time Comes to Stop Oral Anticoagulation: Options and Obstacles

4. Unseen and Unheard: In the Cath Lab, Anti-racism Efforts Fall Short

5. Cardiac Care Feels Staffing Crunch as Big Money Converts COVID-19 Travelers

Shelley Wood is Managing Editor of TCTMD and the Editorial Director at CRF. She did her undergraduate degree at McGill…

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