TCTMD’s Top 10 Most Popular Stories for October 2018

Breaking news on rivaroxaban topped our list this month, followed by some TCT takeaways and top-line results from not-yet-published trials.

TCTMD’s Top 10 Most Popular Stories for October 2018

A Dear Doctor letter sent to physicians earlier this month, announcing that the GALILEO trial testing rivaroxaban in TAVR patients was halted for harm, was the most popular news for TCTMD readers in October 2018. This was followed closely, however, by good news for the same drug in the setting of stable CAD and PAD. Several stories from TCT 2018 continued to make waves, including COAPT, SECURE-PCI, and “telestenting” for long-distance PCI. Additional updates on dabigatran, dapagliflozin, statins, early discharge following PCI, and the new CMS add-on payment for cerebral protection during TAVR rounded out the list this month.

1. 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.

2. FDA Approves Rivaroxaban for CV Event Reduction in CAD and PAD Patients

The expansion shifts the focus to targeting “atherothrombosis” in selected patients with chronic stable disease, according to one expert.

3. My Takeaways From TCT 2018: Sunglasses, Shadows, and the COAPT Eclipse

TCT 2018 will go down as the year that COAPT stole the spotlight. Flooding into its wake are explanations and questions as to what comes next.

4. Statin Preloading Benefit More Pronounced in STEMI Patients: SECURE-PCI

One physician argues: since STEMI patients should be discharged on a statin anyway, why not give them the drug before PCI?

5. ‘Telestenting’ an Early-Days but Enticing Idea for PCI’s Future

Though clinical trials are far away, one researcher is taking steps toward making long-distance PCI a reality.

6. Two Studies Support Safety and Cost-Effectiveness of Same-Day Discharge After Elective PCI

In one study, the cost savings were predicted to exceed $5,000 per case, while another found that earlier discharge did not lead to more readmissions.

7. Dapagliflozin Gets Partial Win in DECLARE-TIMI 58

Top-line results show the SGLT2 inhibitor reduced one of two co-primary endpoints in patients with type 2 diabetes and high CV risk.

8. Add-on Payment Now in Effect for Sentinel Protection Device During TAVR

Cost has often been cited as the chief barrier to using cerebral protection during TAVR. The new add-on payment granted by CMS may help.

9. Dabigatran Trials Come Up Short for Stroke of Unknown Cause and Cerebral Venous Thrombosis

RE-SPECT ESUS and RE-SPECT CVT, presented at the World Stroke Congress, did support the safety of dabigatran versus other treatments.

10. Statin Benefits: Yes for CVD but No for Everything Else, Says New Review

A hint of benefit with CKD likely relates to CV effects, say researchers, who found credible proof that statins help beyond the cardiovascular system.

* * * * *

TCTMD also ran several feature stories this month on everything from industry-funded trials to appropriate use criteria (AUC) in real-life cath labs and a humanitarian project that screened at-risk adults in underserved parts of West Virginia.

The Price of Knowledge: Industry-Sponsored Studies in the Era of Evidence-Based Medicine

The biggest advances in medicine come from companies sponsoring trials in the hopes of turning a profit. What’s the right balance of help and harm?

Survey Says: Interventional Cardiologists Still Divided Over Appropriate Use Criteria

Nearly a decade after the AUC debuted, practice is mixed and only half of interventionalists think these criteria have helped patients and cath labs.

Country Roads: Vulnerable West Virginia Heart Patients Targeted in Outreach Program

The humanitarian effort is designed after similar programs in India and China, the goal being to get neglected patients screened by a cardiologist.

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