THE BE T
Multimedia Highlights
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AF and Diabetes: Major Bleeding
Among Rivaroxaban Users
What’s the Prognostic Impact of CTOs:
A SCAAR Report
Long-term P2Y12 Antagonists Post-MI:
It’s a Trilemma
W. Frank Peacock, MD: “We looked
at patients in the subset who were on
rivaroxaban and had diabetes and atrial
fibrillation. The reason to do this is because,
if you think about the CHAD score, the ‘D’ is
diabetes. So, as a subset, this is a big player.”
Elmir Omerovic, MD, PhD: We found that
in approximately 16% to 18% of patients that
have significant CAD, we also found CTOs.
We also find out that SCAAR has the largest
number of these patients. Previous studies
until recently only reported in the perhaps
hundreds of patients, but we have quite a
substantial number (almost 14,500 patients).
Dimitrios Alexopoulos, MD: It has been well
appreciated recently that the population with
prior MI is a high-risk population. The risk is
not defined within the first year only. So it is
common practice to give a P2Y12 antagonist
for a year, but the risk extends beyond a year.
After that, what?
Mallick A, Gandhi P, Gaggin H, et al.
JCHF. 2016;4(9):749-755.
Thoracoscopic GP Ablation for AF:
Is All Hope Lost for the Plexus?
For Individualized Treatment Selection: Make Way for SYNTAX 2 (Then 3)
Consistent Benefit of Sacubitril/
Valsartan: More from PARADIGM-HF
Joris R. de Groot, MD, PhD: [D]uring the
procedure, we abolished 100% of the activity
as tested with the high-frequency stimulation
in the ablated patients, and found that in 87%
of the patients, the activity remained. But
then during follow-up, we found no difference
in the efficacy or AF recurrence between the
two [study] groups—on the contrary, we found
more serious complications in the ganglionic
plaque group consisting of severe bleedings,
sever sinus node dysfunction,
and pacemaker implantation.
Patrick Serruys, MD, PhD: When the study
was finished, we realized that the SYNTAX
score has strong prognostic value, and
we made that classification 22 and 33
(two numbers that are easy to remember
for t he surgeon and the cardiologist). We
discovered also that with the SYNTAX score,
the anatomic assessment of the coronary
circulation was very important for the
interventional cardiologist.
Scott Solomon, MD: “One question we get
from many of our colleagues and clinicians
is, ‘I have a patient. They have heart failure.
But they’re doing okay. They haven’t been
hospitalized in the past year or so. Why
should I think about switching their ACE
inhibitor and therapy drugs I’m very familiar
with to this new therapy?’ So [in this study]
we asked that question.”
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CardioSource WorldNews
September 2016