April 11, 2019
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ACC intervention highlights: Low-risk TAVR, antithrombotic regimens and more

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NEW ORLEANS — At the American College of Cardiology Scientific Session, history was made when two studies showed that transcatheter aortic valve replacement was equivalent to or better than surgery in low-risk patients, which could greatly expand the population appropriate for TAVR.

Cardiology Today’s Intervention covered that and other game-changing news live, and has compiled a list of the intervention-related highlights from the meeting.

Low-risk TAVR trials represent ‘historic moment’ in care of aortic stenosis

NEW ORLEANS — Transcatheter aortic valve replacement — already a mainstay of treatment for intermediate- and high-risk patients with severe aortic stenosis — may soon become the preferred therapy for low-risk patients as well.

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AUGUSTUS: Dual therapy with apixaban, P2Y12 inhibitor safe in Afib patients post-ACS or PCI

NEW ORLEANS — New data from the AUGUSTUS trial provide insight on the appropriate antithrombotic regimen after ACS or PCI in patients with atrial fibrillation.

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COAPT: Transcatheter mitral valve replacement brings health status improvements

NEW ORLEANS —Two substudies from the COAPT trial presented at the American College of Cardiology Scientific Session found that patients with moderate-to-severe or severe mitral regurgitation who had transcatheter mitral valve repair and guideline-directed medical therapy had improvements in health status as soon as 1 month.

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Balloon-expandable TAVR safe in bicuspid aortic valves

NEW ORLEANS — Patients with bicuspid aortic valves who underwent transcatheter aortic valve replacement with a balloon-expandable valve had similar rates of death and stroke at 1 year, compared with patients with tricuspid aortic valves, according to new data highlighted at the American College of Cardiology Scientific Session.

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BP-lowering effect of renal denervation persists at 6 months in RADIANCE-HTN SOLO

NEW ORLEANS — Endovascular ultrasound renal denervation resulted in BP reductions that were maintained at 6 months, with fewer prescriptions for antihypertension medications needed, compared with a sham procedure in patients with uncontrolled hypertension, researchers reported at the American College of Cardiology Scientific Session.

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Immediate angiography fails to improve survival after cardiac arrest without STEMI

NEW ORLEANS — Among patients revived from out-of-hospital cardiac arrest who had ischemic heart disease but not STEMI, there was no difference in 90-day survival or myocardial injury between immediate and delayed angiography, according to the results of the COACT trial.

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TREAT: Ticagrelor after fibrinolytic therapy may reduce bleeding events after STEMI

NEW ORLEANS — Ticagrelor after fibrinolytic therapy in patients younger than 75 years with STEMI may not reduce the frequency of major CV events at 12 months compared with patients treated with clopidogrel, but it may be safe with regard to major bleeding, according to data from the TREAT trial presented at the American College of Cardiology Scientific Session.

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Survival improved over time in acute aortic dissection

NEW ORLEANS — Since 1996, survival in patients with acute aortic dissection has increased, according to data from the IRAD registry presented at the American College of Cardiology Scientific Session.

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GLASSY: Long-term ticagrelor monotherapy noninferior to DAPT after PCI

NEW ORLEANS — One month of dual antiplatelet therapy followed by ticagrelor monotherapy was noninferior to conventional DAPT to prevent nonfatal MI, all-cause death, nonfatal stroke or urgent target vessel revascularization at 2 years in patients who underwent PCI with a drug-eluting stent, according to data presented at the American College of Cardiology Scientific Session.

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iFR identifies residual ischemia in nearly 25% of patients after PCI

NEW ORLEANS — After angiographically successful PCI, nearly 1 in 4 patients had residual ischemia as shown by instantaneous wave-free ratio measurement, according to the DEFINE-PCI study presented at the American College of Cardiology Scientific Session.

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