June 2021 News Roundup
This month features data on female operators’ outcomes, risk assessment in TAVI, intracardiac thrombus and LVADs, and more.
Every month, Section Editor L.A. McKeown curates a roundup of recent news tidbits from journals and medical meetings around the globe.
Patients of female interventional cardiologists have similar risk-adjusted in-hospital outcomes compared with patients treated by their male colleagues, according to the DISCO study, published in Catheterization and Cardiovascular Interventions. Although female operators accounted for only a small percentage of overall cases, they had a greater percentage of their PCI cases adjudicated as “appropriate” than did male cardiologists (86.64% vs 84.45%; P < 0.0001).
Incorporation of virtual technologies into TAVI clinical care was crucial for many centers during the height of the COVID-19 pandemic. An article in Structural Heart describes how that experience may lead to greater adoption of these tools in minimalist care pathways.
A single-center study from California of 96 predominantly Hispanic or Latino patients hospitalized for COVID-19 found that 91% had abnormal LV systolic function, as assessed by global longitudinal strain (GLS), despite having preserved ejection fraction. Reporting in IJC Heart & Vasculature, investigators say the findings were observed in COVID-19 patients regardless of CVD history, symptoms, or illness severity.
The basic evaluation and management of the most common types of PAD are reviewed and summarized in a new Education in Heart article published online in the journal Heart.
CV disease, hypertension, diabetes, renal disease, and smoking history are all associated with a higher likelihood of severe COVID-19 illness and/or mortality, according to a review of studies published in 2020. In European Heart Journal: Quality Care and Outcomes, researchers say the data suggest that primary and secondary prevention aimed at improving CV health “may also improve outcomes for people following COVID-19.”
Standard risk assessment may not give a complete picture of the risks associated with chronic disease burden in patients prior to TAVI, according to a study published in the Journal of the American Heart Association. In a cohort where 65% had four or more comorbidities at the time of their procedure, 30-day rehospitalization and mortality rates were significantly greater as the number of chronic conditions increased, suggesting that a more-systematic assessment of comorbidities is necessary to determine individual risk.
An automated algorithm could help increase the use of coronary physiological assessment in the cath lab. In a pilot study reported in the Journal of Clinical and Experimental Cardiology, comparison of the automated fractional flow reserve (FFR) program versus wire-based FFR performed by a clinician yielded high rates of sensitivity and specificity that the authors say are encouraging and provide the groundwork for larger trials.
Preexisting intracardiac thrombus is an independent risk factor for stroke or death in the 6 months after undergoing implantation of a left ventricular assist device (LVAD), according to a study published in the Journal of Cardiac Failure. More studies are needed, the authors say, to determine how best to factor intracardiac thrombus presence into preoperative risk assessment and management.
In an analysis of four pooled contemporary CTO-PCI registries, in-stent chronic total occlusions (CTOs) accounted for about 15% of all cases. Both technical and procedural success were high and similar for in-stent restenosis and de novo CTOs, as was the rate of in-hospital MACE, investigators report in JACC: Cardiovascular Interventions.