The HOST-EXAM study (which was prospective, randomized, and open-label, with the participation of 37 Korean sites) was specifically designed to determine the role of aspirin as the long-term antiplatelet therapy of choice after angioplasty with current drug-eluting stents. To this end, the study compared aspirin head-to-head with clopidogrel. Over the course of four years, 5438 patients (mean...
ESC 2021 | RIPCORD-2: Routine FFR Evaluation of All Epicardial Vessels During Angiography
The predecessor of this research—RIPCORD, published in 2014—showed that using fractional flow reserve (FFR) changes the treatment strategy in about 25% of patients. That marked the rise of FFR. In fact, the DEFER, FAME, and FAME 2 studies offered results consistent with the original RIPCORD. In this research, authors tested the hypothesis of systematic use of...
The Long Marathon of Ultrathin vs. 2nd Generation Thin-Strut DES
After 2.5 years of non-stop racing, ultrathin-strut drug-eluting stents (DES) reached the finish line before 2nd generation thin-strut DES. The advantage was in terms of clinically justified lesion revascularization, while rates of infarction, stent thrombosis, cardiac death, and all-cause death were similar. After failure at trying to create new generations of DES based on drugs...
Efficacy of the Novavax Vaccine Against COVID-19: Nanoparticle Technology to the Test
In healthy adults, two doses of the NVX-CoV2373 (Novavax) vaccine has an efficacy of almost 90% against SARS-CoV-2 infection in all severity types. Furthermore, it has proven to be effective against the alpha variant (B.1.1.7). The Novavax vaccine is a recombinant nanoparticle containing full-length spike glycoprotein. It had already been shown to be safe and...
Novel DES Technology Promises to Become the Next DES Generation
The novel technology of drug-eluting stent Supreme was designed to synchronize antiproliferative drug release and leave a base behind to promote healing. Accelerated endothelial healing after antiproliferative drug release may limit the long-term inflammatory response. This multicenter, single-blind study included 1600 patients who were randomized 2:1 to receive drug-eluting stent Supreme vs. a classic permanent-polymer everolimus-eluting...
Differences in American and European Atrial Fibrillation Guidelines
The recent publication of the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) guidelines provided an important update on multiple aspects of the management of atrial fibrillation (AF). However, these guidelines differ in terms of management and recommendation levels. As it might be expected, most differences arose in intermediate cases—both guidelines...
Very Short Dual Antiplatelet Therapy after Complex PCI
The 1-month outcomes of dual antiplatelet therapy (DAPT) followed by clopidogrel monotherapy were comparable to 12-month DAPT in patients with both simple and complex PCI. There was no significant interaction between DAPT period and procedure difficulty. This is a post hoc study of the STOPDAPT-2 that looked at the complex PCI patient subgroup. It is...
Biodegradable Polymer Myth Also Debunked for ACSs
During TCT 2020 a preview of the results of the comparison of drug-eluting stents (DES) with biodegradable-polymer vs. durable-polymer in patients with acute coronary syndrome (ACS) was presented. The fine print and the final paper for HOST-REDUCE-POLYTECH-ACS are now published, and they lower the expectations set on biodegradable polymers. In patients with ACS undergoing angioplasty, biodegradable-polymer...
The Most Read Articles of January in Interventional Cardiology
01- New Valvular Heart Disease Guidelines with Key TAVI and Mitral Regurgitation Updates Valvular heart disease management guidelines were updated last week by the AHA and the ACC. Read more HERE 02- High Risk Anatomy Challenges ISCHEMIA Outcomes According to this recent analysis published in JAHA, patients with stable Ischemic heart disease and high-risk anatomy benefit from revascularization...
More Evidence for Short Term DAPT: Approaching “the Class Effect”
Patients at high risk of bleeding undergoing coronary angioplasty with Orsiro stent can be considered for a short dual antiplatelet scheme. These data come from the SMART-CHOICE study recently published in JAHA, adding the Orsiro stent to the list of devices supporting 3-month DAPT. This study included 2993 patients undergoing coronary angioplasty randomized to 3...