Randomized Trial Comparing a Nano-Coated Coronary Stent and Shorter DAPT Did Not Meet Non-Inferiority Criteria for Thrombotic Events

For patients undergoing percutaneous coronary intervention (PCI) that also require oral anticoagulation, treatment with a nanotechnology polymer-coated stent plus 14-day dual anti-platelet therapy (DAPT) did not reduce bleeding or establish non-inferior outcomes for thrombotic events compared with a drug-eluting stent (DES) and standard three or six-month DAPT therapy.

Read more

Deferral of PCI in FFR-Abnormal Lesions with Preserved Coronary Flow Reserve Is Not Associated with Similar Outcomes as Untreated Lesions with Normal FFR

A new observational study of deferred lesions following combined fractional flow reserve (FFR) and coronary flow reserve (CFR) assessments found that untreated vessels with abnormal FFR but intact CFR do not have non-inferior outcomes compared to those with an FFR greater than 0.8 and a CFR greater than or equal to two when treated medically.

Read more

Fractional Flow Reserve Derived from Computed Tomography Coronary Angiography Did Not Significantly Reduce Costs But Reduced Rates of Invasive Coronary Angiography

In the FORECAST randomized clinical trial, the use of fractional flow reserve management derived from computed tomography (FFRCT) did not significantly reduce costs but did reduce the use of invasive coronary angiography (ICA).

Read more

Meta-Analysis of Bivalirudin vs. Heparin in Patients with MI Examines Mortality and Bleeding Rates

An individual patient data pooled analysis comparing the use of bivalirudin versus heparin in heart attack patients undergoing percutaneous coronary intervention (PCI) found that bivalirudin use was associated with similar overall rates of 30-day mortality across all heart attack patients, but lower rates of serious bleeding events. Moreover, mortality was reduced in patients with ST-segment elevation myocardial infarction (STEMI) who were treated with a post-PCI bivalirudin infusion.

Read more

New Research Supports Initial Conservative Management of Stable Coronary Artery Disease

New study results confirm that guideline-directed medical therapy is as effective as more invasive procedures at preventing death, stroke, and heart attack in patients with stable coronary artery disease (CAD).

The study results suggest that guideline-directed medical therapy should be the initial treatment strategy for patients with stable CAD.

The study results validate the evidence-based, guideline-directed, conservative treatment approach that the cardiovascular specialists at Nuvance Health have always used to treat CAD.

Read more

New Data Show that Patients with Left Main Disease Treated with PCI or CABG Have Similar Composite Outcomes at Five Years

Patients with left main coronary artery disease (LMCAD) typically have a poor prognosis due to the large amount of myocardium at risk. Revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) has been shown to prolong survival in patients with left main disease compared with medical therapy alone. Three-year data from the large-scale randomized ECXEL trial found no significant difference in the composite rate of death, stroke or myocardial infarction (MI) between the two treatments, with a reduction in 30-day major adverse events with PCI. These results were first reported at TCT 2016 and published in NEJM.

Read more