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Cardiology Today's Intervention top 5 articles from July
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Cardiology Today’s Intervention compiled a list of the top 5 stories posted to Healio.com/Intervention in July.
This month, our readers were most interested in 1-year outcomes with thinner-strut drug-eluting stents, the effect of malnutrition on mortality rates in aortic valve replacement, antithrombotic therapy in patients with atrial fibrillation undergoing PCI, a CMS panel hearing on procedure volumes for transcatheter aortic valve replacement, a guideline on imaging after vascular procedures and more.
Thinner-strut DES confer improved 1-year outcomes
Newer-generation ultrathin-strut drug-eluting stents improved 1-year clinical outcomes in patients undergoing PCI compared with contemporary thicker-strut second-generation DES, according to data published in Circulation.
Malnutrition elevates mortality rates after AVR
Mortality rates 1 year after transcatheter or surgical aortic valve replacement are approximately three times higher among older adults with signs and symptoms of malnutrition, researchers reported in Circulation.
A Balancing Act
For patients undergoing PCI, dual antiplatelet therapy plays an important role in preventing thrombotic events. For some patients, however, particularly those with atrial fibrillation who require an anticoagulant for stroke prevention, the risks of treatment may outweigh the benefits.
“In determining the best approach for antithrombotic therapy in patients on oral anticoagulation for AF, it can be difficult to balance the prevention of thrombosis with the risk for bleeding,” Pascal Vranckx, MD, PhD, medical director of the cardiac ICU at Hartcentrum Hasselt and a member of the faculty of medicine and life sciences at Hasselt University in Belgium, told Cardiology Today’s Intervention.
CMS panel: Procedural volume requirements for TAVR may be necessary
The Medicare Evidence Development and Coverage Advisory Committee of the CMS voted that it was moderately confident that there is sufficient evidence to support the need for procedural volume thresholds in centers with new or existing TAVR programs.
The panel convened to reconsider the National Coverage Determination (NCD) for TAVR, with specific focus on TAVR, surgical AVR, PCI and other relevant structural heart disease procedural volume requirements. Despite a general consensus, opinions across each of the nine voting questions posed to the committee varied, as did thoughts among individual panel members, with some questioning the level of available evidence.
New guideline addresses imaging after vascular procedures
The Society for Vascular Surgery released a new guideline outlining which kinds of imaging should be performed after endovascular and open vascular procedures, and how often imaging should be performed.
“It is essential that vascular laboratory testing be performed by qualified personnel using appropriate instrumentation, as demonstrated by individual credentialing and facility accreditation,” the authors wrote.