Interventional innovation, ‘landmark presentations’ promised from TCT 2015

With a team on the ground in San Francisco, Healio.com/Intervention and Healio.com/Cardiology bring you live coverage of top research being presented at the Transcatheter Cardiovascular Therapeutics annual meeting, with perspectives from thought leaders in the field.

The 5-day conference, starting Sunday, features a program agenda that promises practice-changing research — from late-breaking trials to oral abstracts to plenaries — with connectivity among the themes of this year’s meeting.

“The heart of TCT is this new science that’s being presented, as well as live case experiences and sharing of everybody’s global experiences around the world,” Gregg W. Stone, MD, Cardiology Today’s Intervention Editorial Board member and co-director of TCT, said during a media pre-briefing.

Gregg W. Stone

Education in store for attendees

TCT attendees can look forward to four “tremendous” featured clinical research sessions, Stone said, as well as nearly 950 abstracts — to be presented in oral and poster form — carefully selected from approximately 1,800 submissions.

Plenaries, “impactful” didactic and learn-the-technique sessions, and hot-topic lunches promise innumerable opportunities to learn. Additionally, live cases — including the first transcatheter mitral valve replacement, the first implant of a novel interatrial device to treat HF and advanced techniques in complex coronary cases — are among the programming.

“It’s going to be an exciting meeting,” Stone said, noting that a redesigned app offers new features that make it easier for attendees to navigate, network and participate with colleagues.

Top research on the radar

Although the past several meetings have focused on structural heart disease as the “new breakthrough subspecialty,” Stone said the focus of this year’s meeting marks a return to coronary intervention, with several “landmark presentations” on bioresorbable scaffolds.

Attendees can look forward to the first report of 1-year findings from ABSORB III, the U.S. pivotal regulatory approval trial for a bioresorbable vascular scaffold (Absorb, Abbott Vascular) vs. the company’s Xience family of drug-eluting stents, as well as results from ABSORB CHINA, including angiographic follow-up, and ABSORB II with 2-year endpoints.

Also slated for initial reporting are data from the BIOSOLVE II study, which will reveal angiographic and imaging results and clinical outcomes with the drug-coated magnesium dissolvable stent.

“There’s an unprecedented number of the late-breaking trials (and first-line investigations) that are going to be simultaneously published in numerous high-impact journals,” Stone said. Of the 20 late-breaking trials and first-report investigations, presented in batches of five each day, those being published amounts to nearly two-thirds, he added.

But the “avalanche of bioresorbable scaffold data” continues in a dedicated symposium that provides a patient-level pooled meta-analysis of four randomized trials. “It’s got additional power to show differences that none of the individual trials are powered to show,” said Stone, who will present the data.

Results from the large LEADERS FREE trial, evaluating the effect of BioFreedom BA9 DES(Biosensors International) with no polymer coating on duration of dual antiplatelet therapy, is “potentially paradigm-changing,” according to Stone.

Further, the RIVER-PCI trial, which is looking at prognosis with routinely administered anti-ischemic therapy in incomplete revascularization after PCI, has “major implications for looking at adjunct pharmacology.”

In other late-breakers, results on transradial vs. transfemoral access may offer “some very surprising results;” EXPLORE evaluates first-time results for patient prognoses with opening chronic total occlusions after primary angioplasty and acute MI.

Meeting attendees can also look forward to the “potentially very important” 1-year outcomes from the TOTAL trial, with the initial 30-day outcomes negative but an understanding that benefits of aspiration can take time to show, Stone said.

With some studies suggesting patients with diabetes respond as well, or better, to paclitaxel-eluting vs. everolimus-eluting stents, Stone said the TUXEDO trial “will be the best chance we have to put this issue [to] rest.”

The “very interesting, very large-scale” PANDA III study, conducted in China, will reveal patient outcomes with similar stents but different polymers and elution rates, and the IN.PACT SFA trial that examines use of a drug-coated balloon in superficial femoral artery disease will show important 2-year data on treating this chronic condition.

In terms of transcatheter aortic valve replacement, Stone highlighted data from several studies as highly anticipated, including 1-year outcomes from SAPIEN 3 with the now FDA-approved device (Edwards Lifesciences) that has “raised the bar” for mortality and perioperative stroke rates, and long-term results from RESPECT that move forward a “borderline negative” trial another 3 years and could serve as a “strong statement for considering (patent foramen ovale) closure” in cryptogenic stroke.

Also being presented are findings from BRAVO 3 evaluating the use of bivalirudin in patients undergoing TAVR and a Japanese study examining approaches to asymptomatic severe aortic stenosis with results that are “hypothesis-generating if not practice-changing.”

“There’ll be a lot of important new findings that come out of TCT this year, which clearly will impact and improve the outcomes for our patients with [CVD],” Stone said.

Healio.com will be reporting onsite from San Francisco throughout the meeting. Visit Healio.com/ Intervention and Healio.com/Cardiology for breaking news, expert video perspectives and other updates.