After TAVR, patients with no anticoagulation indication are favored by monotherapy with aspirin (ASA) vs. dual antiaggregation therapy (DAPT). This study presented at ESC 2020, simultaneously published in NEJM, seems to go against the latest “fashion” (P2Y12 inhibitor monotherapy) and randomized patients to ASA monotherapy vs. DAPT with clopidogrel for 3 months. Unlike with the...
ESC 2020 | New Drug Improves Functional Capacity in Hypertrophic Cardiomyopathy
In patients with hypertrophic cardiomyopathy, myosin inhibitor mavacamten plus optimal medical therapy improved hemodynamics, functional capacity, and symptoms. Mavacamten is the first myosin inhibitor drug of its class. Presented virtually at the European Society of Cardiology 2020 Congress (ESC 2020) and published simultaneously in The Lancet, the EXPLORER-HCM study showed that 37% of patients who received...
ESC 2020 | Atrial Fibrillation and Rhythm Control: A Matter of Time?
Early rhythm control therapy in patients recently diagnosed with atrial fibrillation reduces the risk of cardiovascular events compared against the usual treatment of frequency control. These data come from the EAST-AFNET 4 trial recently presented at ESC 2020, simultaneously published in NEJM. These data suggest that we should offer patients early rhythm control therapy to...
Subintimal Re-Entry in CTO Improves Outcomes
Courtesy of Dr. Carlos Fava. Chronic total occlusions (CTO) are still one of the greatest challenges in our field, thus forcing the development of different complex strategies to resolve them. Additionally, the use of imaging techniques during these procedures has improved long-term results. The CONSISTENT CTO (Conventional Antegrade Versus Sub-Intimal Synergy Stenting in Chronic Total Occlusions)...
The Whole Toolkit Tested in Carotid Artery Stenting
This study sought to randomly compare the double-layer Roadsaver stent (Terumo) with the single-layer Carotid Wallstent device (Boston) in association with either distal filter-like embolic protection device FilterWire (Boston) or proximal protection device Mo.Ma (Medtronic) in patients with lipid-rich carotid plaques. This is a very interesting work because there are no head-to-head simultaneous comparisons between...
Virtual ACC 2020 | TICO: Ticagrelor Monotherapy in Acute Coronary Syndromes
Switching to ticagrelor monotherapy after 3 months of dual antiplatelet therapy reduces major bleeding without paying a price in terms of ischemic events, compared with dual antiplatelet therapy for a year, in patients who had acute coronary syndrome and underwent angioplasty with a second-generation drug-eluting stent. Interrupting aspirin at 3 months and switching it for ticagrelor reduces...
Virtual ACC 2020 | PRONOMOS: Rivaroxaban Superior to Enoxaparin in Orthopedic Surgery
According to this new study presented virtually at the suspended American College of Cardiology (ACC) 2020 Scientific Session and published simultaneously in the New England Journal of Medicine (NEJM), rivaroxaban is more effective than enoxaparin in preventing venous thromboembolism during a period of immobilization after nonmajor orthopedic surgery of a lower limb. After an orthopedic...
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 | 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...