THE BE T
Multimedia Highlights
From the CardioSource WorldNews YouTube Channel | Scan the QR code to watch the full video
The First Decade of Appropriate Use
Criteria (AUC) for Cardiac Imaging
A NOTION of Things to Come in TAVR
Stents vs. CABG for Left Main Disease:
5-year Results from PRECOMBAT
Todd D. Miller, MD: “[With the criteria in
place] you have a little bit of improvement in
appropriate studies, [and] some increase in
inappropriate studies. I think that indicates
that maybe we’re able to categorize studies
more effectively. But it really doesn’t seem to
be changing physician behavior.”
Hans Gustav Hørsted Thyregod, MD: “The
NOTION trial is unique in that it is the first
randomized control trial [for] an all-comers
population. And since the majority of patients
with severe aortic valve stenosis are low-risk
patients, we included almost 80% of patients
with a low risk for surgery. [… After 1 year]
the transcatheter patients did better than the
surgical patients.”
Miller TD J, Askew JW. J Am Coll
Cardiol. 2015;65(8):774-6.
Thyregod H, et al. J Am Coll Cardiol.
2015;65:2184-94.
Ahn JM, Roh JH, Kim YH, et al. J Am
Coll Cardiol. 2015;65(20):2198-206.
doi:10.1016/j.jacc.2015.03.033.
Same-Day Discharge After Elective ICD
Placement
The LEGACY of Sustained Weight Loss:
Reduction of AF Burden
Consequences of Early vs. Late DAPT
Non-Adherence
Paul Hess, MD: “The current practice
standard is largely to have the ICD placement
to take place on one day and have the
discharge take place on the following day.
[But] 5% of procedures, these days, are
actually discharged the same day. […] A very
surprising finding was the safety signal was
very nice insofar as there did not appear
to be any significant differences between
groups that are discharged the day after ICD
placement and those that are
discharged the same day.”
Prashanthan Sanders, MBBS, PhD (with
Rajeev K. Pathak, MBBS): “In the Directed
Management, we have a separate clinic that
runs a weight and risk-factor management
side—they don’t manage the fibrillation…We
found this is a really effective way of gaining
compliance with patients [and] motivating
them to take control of their disease […] At
5 years, most of these patients were able to
keep that weight off.”
Donald E. Cutlip, MD: “We know that
prolonged DAPT is the answer, overall. But
for patients who have to stop, it seems to be
that 6 months is a critical time point […] If you
know a patient is at high risk for bleeding, it
may still be that a bare-metal stent is the best
choice so we know we can shorten that DAPT
duration.”
Pathak R, Middledorp M, Meredith M, et
al. J Am Coll Cardiol. 2015; doi:10.1016/j.
jacc.2015.03.002.
Cutlip DE, Kereiakes DJ, Laura
Mauri L, et al. J Am Coll Cardiol Intv.
2015;8(3):404-10.
Hess PL, et al. J Am Coll Cardiol.
2015;65:955-7.
10
CardioSource WorldNews
Seung-Jung Park, MD: [“For multi-vessel
disease] surgery is clearly superior to any
to PCI […] However, Left Main Disease
intervention is a totally different concept
with different data. […] Main PCI is quiet
acceptab le rather than the surgery. This is a
big change from the last 15 years.”
September 2015