Despite large reductions in blood pressure seen in early studies of renal denervation, the SYMPLICITY HTN-3 randomized trial failed to show a reduction in systolic blood pressure with renal denervation when compared to medical therapy alone. As a result, interest in renal denervation as a treatment for resistant hypertension has waned. In the DENERHTN trial, […]
Category: Interventional cardiology
Temporal trends towards increased mortality despite Improved door-to-balloon times in ST-elevation myocardial infarction
A short door-to-balloon time (D2B) is considered a quality of care measure for patients of ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention (pPCI). However, recent literature has documented reductions in D2B that were not associated with improved STEMI mortality. Using the National Cardiovascular Data Registry (NCDR) CathPCI Registry, Nallamothu et al. assessed this apparent […]
Outcomes with increased length of dual antiplatelet therapy after PCI
The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is uncertain. Although observational studies have suggested DAPT for longer than a year post-PCI reduces ischemic events, other studies suggest longer durations of DAPT confer no benefits despite increased bleeding risk. This randomized controlled trial evaluated patient outcomes with 12-months vs 30-months […]
Ivabradine ineffective as add-on therapy for stable ischemic heart disease
Ivabradine reduces heart rate without affecting blood pressure or left ventricular systolic performance. Given studies demonstrating a relationship between heart rate and cardiovascular risk, modifying heart rate with ivabradine may reduce risk in patients with coronary disease. In the Study Assessing the Morbidity–Mortality Benefits of the If Inhibitor Ivabradine in Patients with Coronary Artery Disease […]
Risks and Benefits of Percutaneous Coronary Interventions in Stable Coronary Disease: A Qualitative Analysis of Cardiologists’ Bedside Discussions
Although the benefits of PCI for stable CAD are limited to symptom reduction, prior studies have shown that patients often believe PCI for stable coronary artery disease (CAD) will mitigate the future risks of myocardial infarction or death. This study examined discussions between cardiologists and patients regarding angiograms and PCI in stable CAD to identify […]
Dual Antiplatelet Therapy Beyond 1-year after Percutaneous Coronary Interventions for Stable Coronary Artery Disease Results in Harm
The benefit of extended dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is uncertain. The ARTIC-Interruption Trial examined discontinuation of DAPT at 1-year after PCI vs continuation for an additional 6-18 months. The study randomized patients 1-year after PCI to continuation (N=635) or interruption (N=624) groups, and examined the primary composite endpoint of death, […]
No benefit to thrombus aspiration in STEMI
Thrombus aspiration in acute ST-segment elevation myocardial infarction (STEMI) is clinically appealing and often used prior to PCI. However, the majority of trials evaluating thrombus aspiration have failed to demonstrate significant mortality benefit. The Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia (TASTE) trial is a multi-center study that randomized a total of 7244 presenting […]
Patient Understanding of Elective PCI Benefit Varies by Hospital
Elective percutaneous coronary intervention (PCI) does not prevent mortality or myocardial infarction, but is an important therapy for the relief of ischemic symptoms. However, a majority of patients believe that PCI for stable coronary artery disease (CAD) will prolong their lives and prevent heart attacks. In this study, investigators surveyed 991 patients undergoing elective PCI […]
Transcatheter aortic valve implantation – are we moving from equivalent to preferred in high-risk surgical patients?
Transcatheter aortic valve implantation (TAVI) has expanded the options for the treatment of severe aortic stenosis, particularly in patients for whom the surgical risk of valve replacement is felt to be prohibitive. Prior studies have demonstrated TAVI reduces mortality relative to medical management among patients unable to undergo valve surgery. Among patients considered to be […]
No Benefit from Extended Dual Anti-Platelet Therapy?
The PARIS (patterns of non-adherence to anti-platelet regimens in stented patients) registry is a prospective observational study of patients from the US and Europe who were discharged on dual anti-platelet therapy (DAPT) following coronary stenting. Among 5018 patients from this registry, the rates of physician recommended discontinuation, brief interruption (i.e. for surgery), or disruption (ie […]