Ticagrelor monotherapy after 3 months of dual antiplatelet therapy in patients who experienced ST-segment elevation infarction significantly reduces major bleeding without increasing ischemic risk. This pre-specified analysis of the TICO study shows that ticagrelor monotherapy is safe even in patients with higher ischemic risk. Interrupting aspirin use after 3 months of dual antiplatelet therapy and continuing treatment<a href="https://solaci.org/en/2020/10/22/tct-2020-ticagrelor-monotherapy-after-st-segment-elevation-infarction/" title="Read more" >...</a>
TCT 2020 | Initial Studies Show Incredible Results with Lithotripsy in Calcified Lesions
Intravascular coronary lithotripsy shows promise for the improvement of angioplasty in severely calcified lesions, according to data from the DISRUPT CAD III study, published in JACC and simultaneously presented at the TCT 2020 Congress. Calcification in all patients enrolled was highly severe, with an average length of 48 mm, and side-branch involvement in 30% of cases. Lithotripsy,<a href="https://solaci.org/en/2020/10/21/tct-2020-initial-studies-show-incredible-results-with-lithotripsy-in-calcified-lesions/" title="Read more" >...</a>
TCT 2020 | Xience in Favor of Short Dual Antiaggregation Therapy with High Bleeding Risk
Following with aspirin alone after a short period of dual antiaggregation therapy (DAPT), 1 to 3 months, did not increase ischemic events in patients receiving a Xience stent while significantly reducing bleeding. This study endorses the safety of short DAPT with contemporary drug eluting stents (DES) in patients presenting high bleeding risk. The XIENCE Short<a href="https://solaci.org/en/2020/10/21/tct-2020-xience-in-favor-of-short-dual-antiaggregation-therapy-with-high-bleeding-risk/" title="Read more" >...</a>
How To De-Escalate Prasugrel After Acute Coronary Syndrome?
Patients who undergo coronary angioplasty after acute coronary syndrome could de-escalate dual antiplatelet therapy with prasugrel to maintain the protection against ischemic events while lowering their hemorrhagic risk. The HOST-REDUCE-POLYTECH-ACS study (recently published in The Lancet) included 2338 patients who underwent coronary angioplasty in a setting of acute coronary syndrome. Patients were randomized to a year-long<a href="https://solaci.org/en/2020/10/21/how-to-de-escalate-prasugrel-after-acute-coronary-syndrome/" title="Read more" >...</a>
Drug-Coated Balloons in Critical Ischemia: The Paradigm of Randomized Evidence vs. Logbooks
This research, which included thousands of patients treated for chronic inferior limb ischemia with drug-coated balloons, did not show an association between said devices and the increased mortality observed in some randomized trials. The long-term evidence from plenty of real-world patients contradicts what has been shown in randomized trials, leaving an information gap. Endovascular revascularization<a href="https://solaci.org/en/2020/10/13/drug-coated-balloons-in-critical-ischemia-the-paradigm-of-randomized-evidence-vs-logbooks/" title="Read more" >...</a>
The Most Read Articles of September in Interventional Cardiology
01- ESC 2020 | New European Guidelines on Non-ST-Segment Elevation Acute Coronary Syndromes: What’s New? The new European guidelines on NON-ST-segment elevation acute coronary syndromes (NSTE ACS) were presented virtually during the European Society of Cardiology 2020 Congress (ESC 2020) and published in Eur Heart J. Read more HERE 02- Ticagrelor to Improve Venous Graft Patency Saphenous<a href="https://solaci.org/en/2020/10/09/the-most-read-articles-of-september-in-interventional-cardiology/" title="Read more" >...</a>
Post TAVR ASA Monotherapy Consolidates
This meta-analysis to be published in J Am Cardiol supports the use of aspirin monotherapy (ASA) after transcatheter aortic valve replacement (TAVR). The use of aspirin alone is associated to less bleeding without increased ischemic events such as strokes or mortality. The combined outcomes of four studies, including the recently published POPular TAVI (cohort A),<a href="https://solaci.org/en/2020/10/07/post-tavr-asa-monotherapy-consolidates/" title="Read more" >...</a>
IN.PACT AV ACCESS | Drug-Coated Balloons for Dialysis Fistulas
The IN.PACT AV Access study, recently published in the New England Journal of Medicine (NEJM), showed that drug-coated balloons are superior for the treatment of stenotic lesions in arteriovenous fistulas for dialysis compared with conventional balloons. Dialysis fistulas are an unknown territory for paclitaxel-eluting balloons, since the formal recommendation in the guidelines is conventional angioplasty<a href="https://solaci.org/en/2020/09/30/in-pact-av-access-drug-coated-balloons-for-dialysis-fistulas/" title="Read more" >...</a>
Same Contrast Dose, Different Risk of Kidney Injury, Depending on Procedure
The risk of contrast induced kidney injury is significantly lower in patients receiving transcatheter aortic valve replacement (TAVR) compared against patients getting a coronary angiography or angioplasty. This is true even for valvular heart disease patients with higher risk profiles. Differences in contrast-induced acute kidney injury between TAVR or coronary patients had not been previously<a href="https://solaci.org/en/2020/09/16/same-contrast-dose-different-risk-of-kidney-injury-depending-on-procedure/" title="Read more" >...</a>
ESC 2020 | Against the Grain, ASA Monotherapy Appears Superior after TAVR
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<a href="https://solaci.org/en/2020/09/03/esc-2020-against-the-grain-asa-monotherapy-appears-superior-after-tavr/" title="Read more" >...</a>