Interventional corner monthly newsletter

[Cerebrium]

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From: in...@theheart.org <in...@theheart.org >
Date: 07 Dec 2005 15:48:35 -0500
Subject: Interventional corner monthly newsletter
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UPCOMING LIVE CONFERENCE Coronary Stenting: Upsides and Downsides with Bernhard Meier MD University Hospital, Bern, Switzerland CME provider: Medical Education Solutions Group. Supported by unrestricted educational grants from The sanofi-aventis Group, Datascope Corp., Eli Lilly and Company, Medtronic Vascular and Cordis Cardiology. NEWLY ARCHIVED PROGRAMS The STEEPLE Trial: Enoxaparin in Percutaneous Coronary with Steven R Steinhubl MD University of Kentucky, Lexington, KY CME provider: Medical Education Solutions Group. Supported by unrestricted educational grants from The sanofi-aventis Group, Datascope Corp., Eli Lilly and Company, Medtronic Vascular and Cordis Cardiology. HEARTWIRE > INTERVENTIONAL CARDIOLOGY Dramatic decline in emergency CABG following angioplasty A new retrospective review of data from the Mayo Clinic shows a dramatic 90% drop in the need for emergency bypass after angioplasty over the last quarter century. This study has established an important benchmark for interventionalists, says an editorial, but should not be used to justify angioplasty without surgical backup. The senior author from the Mayo Clinic disagrees, however, and says low-risk procedures can be done safely without on-site OR. J Am Coll Cardiol [1 Dec] New PCI guidelines released by AHA, ACC, SCAI Spokespersons for all three organizations highlighted some of the new recommendations or improvements to the new guidelines when they were released to coincide with the American Heart Association Scientific Sessions 2005. [18 Nov] Hybrid revascularization with robotic surgery plus stenting shows promise Combining PCI/stenting with robotic totally endoscopic coronary artery bypass offers patients the best of both worlds, a new study suggests, although attitudes and the technology itself still have room for change. (AHA Scientific Sessions 2005.) [16 Nov] ASSENT-4 90 day results: Lots of lessons learned The 90-day results (the primary end point) of the ASSENT-4 study comparing full-dose TNK-facilitated PCI vs primary PCI alone still show a worse outcome in the facilitated group, but the mortality difference between the two arms is no longer significant. And in patients randomized in the ambulance, those in the TNK-plus-PCI group actually did better. (AHA Scientific Sessions 2005.) [16 Nov] Eptifibatide started in the ED improves blood flow, myocardial perfusion Whether a strategy of starting eptifibatide in the emergency room instead of in the cath lab also translates into improved clinical outcomes is unknown, although the TIMI blood-flow and perfusion measurements are promising, investigators say. The next trial may need to randomize emergency-room eptifibatide against the increasingly popular strategy of high-dose clopidogrel plus heparin, one expert observes. (AHA Scientific Sessions 2005.) [13 Nov] PREVENT-4: Transcription-factor inhibitor fails to prolong SVG coronary-bypass patency Nor did the attempt to suppress genetic mechanisms contributing to neointimal hyperplasia reduce the risk of clinical events in the phase 3 trial, which used an unusual method to pretreat the vein grafts before implantation. (JAMA; AHA Scientific Sessions 2005.) [13 Nov] Go EASY: Transradial PCI is safe, effective, and not as complicated as myth would have it As previously reported by heartwire, the EASY trial results should help boost use of transradial PCI, in combination with a bolus-only dose of abciximab, to permit same-day hospital discharge. (AHA Scientific Sessions 2005.) [13 Nov] Cath-lab clogging, fear of failure, imperfect tools thwart wider use of PCI for CTOs Chronic total occlusions are the most common coronary lesion, yet less than 10% are treated percutaneously. Experts say drug-eluting stents have solved the issue of long-term outcomes following recanalization of CTOs, but laborious procedures, failed crossing attempts, and inadequate technology still mean many CTOs are sent to surgery or left untreated. [7 Nov] No benefit of 900-mg over 600-mg clopidogrel pre-PCI? The ISAR-CHOICE study has suggested that a 900-mg dose of clopidogrel does not provide any more platelet inhibition than a 600-mg dose and that the reason for this is limited absorption of the drug. The results appear to conflict with the ALBION study reported earlier this year, or do they? Circulation [2 Nov] Don't want mail? Click here to be removed from this mailing list. Can't view HTML email? Click here if you want a plain text version. Can't see the images? Click here to view this newsletter online at theheart.org. © 2005 theheart.org