TCTMD’s Top 10 Most Popular Stories for September 2016

Editor’s Corner

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September was a big meeting month for TCTMD, with several stories from the European Society of Cardiology Congress and PCR London Valves making the top 10 list. These included studies of bare-metal versus drug-eluting stents, valve thrombosis, dual antiplatelet therapy, mitral valve innovations, and new cholesterol guidelines. Rounding out the list is a feature story on the Centers for Medicare & Medicaid Services plan to bundle payments for cardiac care, a review of stroke risk in TAVR, and a look at the dire prognosis of elderly patients with asymptomatic aortic stenosis.  

 

My Takeaways From ESC 2016: Eye-Rolling, Disappointments, and a Sobering Comeuppance  

The big news of the meeting slid swiftly off the twirled fork of my memory like a buttery strand of cacio e pepe. Two reasons? Logistical snafus that became the main talking point from the meeting coupled with a line-up of “hotlines” that were mostly lukewarm.

NORSTENT: Do Modern-day Bare-Metal Stents Stand Up to Drug-Eluting Stents? 

The largest randomized stent trial in history has found no difference in the study’s primary composite endpoint at 5 years but did deliver a difference in repeat revascularization rates between groups.

Valve Thrombosis After TAVR Linked to Larger Device Size, Lack of Warfarin Therapy 

Adding to what has been a somewhat muddled issue, a new single-center study has identified post-TAVR valve thrombosis in 7% of patients using multidetector CT. The vast majority of cases, however, were asymptomatic.

Short-term DAPT Not Necessarily the Best Option for All, Especially After Complex PCI 

Much of the conversation around individualizing decisions on dual antiplatelet therapy duration after PCI has focused on clinical parameters, but a new study advocates integrating anatomical factors in order to more precisely prevent adverse outcomes.

Grumbling Over Bundling: Cardiologists React Warily to Plans for Lump-Sum Payments for Cardiac Care  

Though the potential for streamlined and more team-based care is there, physicians tell TCTMD they worry about unintended consequences.

Innovation Overload? Too Many Novel Ideas May Be Holding Back Progress in Transcatheter Mitral Valve Technologies  

There’s new appreciation that transcatheter mitral valve therapies can’t follow the path paved by TAVR. But other forces may also be bogging them down.

Elderly Asymptomatic Patients With Severe AS Are Often Treated Too Late 

Many die within 3 years and some have mobility issues masking early symptoms that would otherwise indicate the need for valve replacement, a small, prospective study suggests.

Focus on LDL Cholesterol Targets With Statin Therapy, New ESC-EAS Cholesterol Guidelines Say 

The European advice diverges from US guidelines, staying the course on treating very-high-risk and high-risk patients to hard LDL cholesterol targets.   

Stroke Risk With TAVR: In-Depth Review of PARTNER and CoreValve Data Reveals Opportunities and Unknowns 

Two comprehensive analyses of cerebrovascular events in the major randomized controlled trials of TAVR are shedding new light on both the timing and risk factors for stroke, even as the therapy moves into younger lower risk patients.

Battle of the Brits: BMJ, Lancet Continue Sniping Over Statins 

Top editors are sparring over how the UK’s Committee on Publication Ethics (COPE) responded to questions about the BMJ’s handling of two papers that contained statements exaggerating the risks of statin therapy.

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Our conference news section has all our coverage of the ESC Congress in Rome, VIVA in Las Vegas, and PCR London Valves. Remember, if you don’t have time to read the top news of the month, consider listening to it instead. Our Heart Sounds podcast recaps some of our biggest—or quirkiest—stories each month. You can stream or download Heart Sounds along with two other podcasts from our Pulse of Cardiology network.

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