After 10 years of follow-up, there were no significant differences in the rates of major adverse cardiovascular or cerebrovascular events among patients with left main coronary artery disease randomized to angioplasty or surgery. Since this was the first study to randomize patients with left main coronary artery disease to angioplasty or surgery, it enrolled very few…
Virtual ACC 2020 | TWILIGHT-COMPLEX: Ticagrelor Monotherapy in the Most “Dangerous” Angioplasties
The original TWILIGHT findings in more than 9000 patients who underwent angioplasty were presented last year at TCT and showed a 3.1% absolute risk reduction in BARC 2, 3, or 5 bleeding with no increase in death, infarction, or stroke in patients who received ticagrelor and placebo compared with patients who received ticagrelor and aspirin. All patients…
Virtual ACC 2020 | First Results of Evolut in Low-Risk Bicuspid Valves
The initial results of this study presented “virtually” at the American College of Cardiology (ACC) 2020 Scientific Session suggest that patients with severe bicuspid aortic stenosis can be treated with self-expandable valve Evolut. This is a small study presenting its 30-day outcomes. There is still a long way to go. The rate of all-cause mortality…
Virtual ACC 2020 | TWILIGHT-DM: Ticagrelor Monotherapy in Diabetic Patients
In parallel to the TWILIGHT in patients with complex PCI, Dr. Angiolillo virtually presented the sub-study in diabetic patients, and it was published simultaneously in J Am Coll Cardiol. This study focuses on the clinical complexity of patients, rather than the technical complexity of the procedure itself. The TWILIGHT-DM analyzed 2620 diabetic patients from the…
Virtual ACC 2020 | POPULAR TAVR: Post TAVR Anticoagulation without Clopidogrel?
In patients undergoing transcatheter aortic valve replacement (TAVR) that also required anticoagulation for another indication (mostly atrial fibrillation), the incidence of major bleeding between month 1 and 12 was lower in those receiving only anticoagulation instead of anticoagulation + clopidogrel. The present study presented as part of the scientific sessions at the virtual ACC 2020,…
Virtual ACC 2020 | Antidote for Life-Threatening Bleeding with New Anticoagulant Agents
Among patients hospitalized with life-threatening or uncontrolled bleeding under treatment with direct factor Xa inhibition, anticoagulation reversal with andexanet alfa (Andexxa) was associated with low mortality rates. These promising results have multiple limitations, particularly the lack of definition on bleeding severity. One of the studies testing the new antidote used propensity-score matching, and there were lower…
ACC 2020 Virtual | ISCHEMIA: Quality of Life, Not a Soft Endpoint
In the general study, an invasive strategy followed by revascularization (when necessary) vs. an initially conservative strategy with OMT resulted similar in patients with stable CAD with moderate to severe ischemia. A secondary end point of this analysis were angina symptoms and quality of life. Angina symptoms, functional activity and quality of life were assessed…
Virtual ACC 2020 | Relationship between Ischemia Severity and CAD
The ISCHEMIA trial enables countless sub-studies. Many of them have made part of the virtual ACC 2020, and among them you will find the present study. This analysis finds it is the anatomy — rather than ischemia — which predicts events. And even more interesting is the fact that revascularizing this particular anatomy will not…
Virtual ACC 2020 | Controversial Trial ISCHEMIA Finally in NEJM
In November 2019, during the American Heart Association (AHA) 2019 Scientific Sessions, researchers presented this revolutionary trial that called the attention of all cardiologists. We had to wait until March to read the fine print; back then, a global pandemic such as the current one seemed out of a science-fiction tale. The world has changed…
Virtual ACC 2020 | Colchicine After Infarction: Good Results and Cost-Effectiveness
Low doses of colchicine reduce the risk of ischemic events after an acute myocardial infarction, according to the COLCOT trial, originally presented at the American Heart Association (AHA) 2019 Scientific Session and simultaneously published in the New England Journal of Medicine (NEJM). The new information featured at the virtual ACC 2020 refers to its cost-effectiveness. Colchicine…