TCTMD’s Top 10 Most Popular Stories for March 2019

Top stories for the month of March included TCTMD’s coverage of the low-risk TAVR trials, AUGUSTUS, and a range of other key studies from the American College of Cardiology 2019 Scientific Session. New developments in the paclitaxel-PAD device saga also made the list, including the US Food and Drug Administration’s announcement that it was advising against use of the drug-coated balloons and stents while continuing to investigate the problem. Some CRT 2019 news also made the top 10 this month, as did the FDA’s decision to extend the indication for MitraClip.

1. 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.

2. 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.

3. FDA Analysis Points to Higher Death Risk With Paclitaxel-Based Devices for PAD

The agency now says that paclitaxel-based balloons and stents should be reserved for those at particularly high risk of restenosis

4. Dropping Aspirin: Two Trials Explore P2Y12 Monotherapy After Short-term DAPT Post-PCI

The findings could “change the paradigm” of post-PCI antiplatelet therapy choices in noncomplex patients, experts say.

5. FDA Extends MitraClip Indication to Include Functional MR

The expanded approval, based on COAPT, means that a far larger proportion of mitral regurgitation patients will be eligible for percutaneous repair.

6. SAFARI Surprise: No Survival or Bleeding Advantage With Radial Over Femoral Access in STEMI

The underpowered trial won’t change things for some proponents of radial PCI, but other operators were reassured and relieved by the results.

7. COACT: Delayed Angiography Does Not Compromise Survival in Cardiac Arrest Patients Without STEMI

For many interventional cardiologists, the findings translate into them getting up less in the middle of the night for emergency catheterizations.

8. New Primary Prevention Guidelines Axe Aspirin, Pushing Routine Check-ins, Social Clues Instead

The ACC/AHA released new primary prevention guidelines that focus on lifestyle, diet, and socioeconomic factors to lower the risk of CVD.

9. Acknowledgment of Safety Signal for Paclitaxel Devices in PAD May Mark Sea Change in Controversy

Another daylong session brought together the endovascular community, but this time with less sniping and more calls for action.

10. Adverse Events Reports for Guide Extension Catheter Should Spur Cautious Use

Devices like the GuideLiner and Guidezilla may be helpful in complex PCI cases, but operators should take care with their use, experts warn.