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Eye on Intervention Blog: Physicians Report on SCAI 2015 Trials, Sessions, Hot Topics
Last week in San Diego, journalists and physician-bloggers reported on key happenings at the SCAI 2015 Scientific Sessions. For a sample of media coverage, scroll down through this issue of SCAI This Week, and for the insights of SCAI members who blogged during late-breaking clinical trial presentations as well as several key sessions, check out the Eye on Intervention blog.
Posted so far:
SCAI 2015 blog reports will continue for the next several days, so check back often, and join us on Twitter to join the conversation. Use #SCAI2015.
- 'Quality' training during interventional fellowship, by Dmitriy N. Feldman, MD, FSCAI
- Lessons learned from new trials of prasugrel in patients with ACS, by Payam Dehghani, MD, FSCAI
- An in-depth look at the ORBIT II trial, by Payam Dehghani, MD, FSCAI
- The new frontier: Interventional cardiology and technology, by Jeffrey M. Schussler, MD, FSCAI
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SCAI Show Booth #218
Press Play: Watch SCAI TV for Annual Meeting News, SCAI Initiative Updates
Just press the Play button to get caught up on a wide variety of SCAI 2015 presentations as well as Society initiatives. Where? At SCAI-TV, the Society's popular YouTube channel. During the SCAI 2015 Scientific Sessions, more than 40 new interviews were posted, all featuring conversations with annual meeting faculty and SCAI member-volunteers. SCAI teamed up with ClinicalTrialResults.org and its anchor, C. Michael Gibson, MD, FSCAI, to highlight hot topics you'll want to watch. Here's a small sample:
And many more! Log on to SCAI-TV and press Play. Future issues of SCAI This Week will deliver more viewing recommendations.
- Afib & PCI, with C. Michael Gibson, MD, FSCAI, and Roxana Mehran, MD, FSCAI
- Future of clinical research in interventional cardiology, with Robert Harrington, MD, FSCAI
- How innovation & technology are transforming interventional cardiology, with Peter Fitzgerald, MD, PhD
- Left atrial appendage update & predictions, with Zoltan Turi, MD, MSCAI
- Occupational health hazards & interventional cardiology, with Charles Chambers, MD, MSCAI
- Research for All bill introduced in the U.S House of Representatives, with Cindy Grines, MD, FSCAI
- Superficial femoral artery interventions, including drug-eluting balloons, with Michael R. Jaff, DO, FSCAI, and James R. Wilentz, MD, FSCAI
- SCAI's Unbroken Hearts campaign, with Robert Applegate, MD, FSCAI
Video production at SCAI 2015 is sponsored in part by Medtronic. We gratefully acknowledge this support while taking sole responsibility for all content developed and disseminated through the program.
Image of the Week: Should We Stent All STEMI?
Hoang Thai, MD, reviews a case of a 49-year-old patient admitted with an inferior STEMI.
Is Informed Consent Needed in STEMI Trials? Ethical Questions From the HEAT-PPCI Fallout
Is informed consent necessary to randomize patients with ST-segment elevation MI into clinical trials?
That was the question two experts grappled with this week at the SCAI 2015 Scientific Sessions, a debate that had its origins in the How Effective Are Antithrombotic Therapies in Primary PCI clinical trial presented in early 2014.
Intensive Tx Fails to Slow Atherosclerosis
Aggressive blood pressure and lipid-lowering treatment after stenting had the expected effect on those surrogate markers but didn't slow down atherosclerosis any better in the Japanese MILLION trial. Plaque volume fell to a similar degree whether the target was under 120/70 mmHg and 70 mg/dL LDL cholesterol or a more standard 140/90 mmHg and 100 mg/dL LDL cholesterol, Masa-aki Kawashiri, MD, of Japan's Kanazawa University and colleagues found.
Related: MILLION Study Presented at SCAI (Cardiac Interventions Today)
Both Standard and Aggressive Treatment Provide Similar Benefit in Reducing Atherosclerosis (SCAI via Medical Xpress)
Techniques to Lower Radiation Dose in TAVR Feasible
In patients undergoing TAVR, simple methods can be used to cut radiation dose by more than 25 percent without adversely impacting outcomes or how the procedure is carried out in the cath lab, according a single-center study published online April 24 in Catheterization and Cardiovascular Interventions.
Researchers led by Mark S. Spence, MD, of Royal Victoria Hospital, looked at data on radiation usage in 72 consecutive patients who underwent TAVR at their institution over an 11-month period.
TRIAGE Study Shows Risk Algorithm Helps Identify Patients Who May Benefit From More Intensive Antiplatelet Medication
Cardiac Interventions Today
SCAI announced that a risk assessment algorithm combining clinical risk factors and platelet function test results may help interventional cardiologists better identify patients who stand to benefit from intensive antiplatelet medication after percutaneous coronary intervention.
These findings from the TRIAGE study were presented by Jaya Chandrasekhar, MD, as a late-breaking clinical trial at the SCAI 2015 Scientific Sessions being held May 6-9 in San Diego, California.
Related: SCAI 2015: Results of the TRIAGE Study (SCAI)
Cilostazol Bridging Effective in Transitioning Off DAPT Post-Op
Monthly Prescribing Reference
Cilostazol given prior to a surgical procedure resulted in a safer transition off dual antiplatelet therapy by reducing the risk of bleeding during the operation in patients with a high-risk paclitaxel drug-eluting stent, a study has shown. This late-breaking clinical trial was presented at the Society for Cardiovascular Angiography and Interventions 2015 Scientific Sessions.
Related: SCAI 2015: OUTSIDE START Cilostazol Bridging Study (SCAI)
OUTSIDE START Study Finds Bridge Therapy Effective Even in High-Risk Patients (SCAI)
OUTSIDE START Shows Effectiveness of Bridge Therapy Using Cilostazol (Cardiac Interventions Today)
Physician Dissatisfaction With MOC Goes Mainstream, Inspires Activism
One year ago, the changes made to the maintenance of certification program run by the American Board of Internal Medicine were only beginning to irk interventionalists. But the saga of nailing down the most effective way to recertify physicians has now gone mainstream, with doctors from every specialty having an opinion, and has given rise to a potential alternative to maintenance of certification.
SCAI 2015: Orbital Atherectomy Sustains its Benefits at 2 Years
An atherectomy device that "sands" calcified lesions in coronary arteries before stenting proved to be effective and durable at two years, and possibly even cost-effective, in a late-breaking clinical trial unveiled May 7.
Jeffrey Chambers, MD, FSCAI, director of the Cardiac Catheterization Laboratory at Mercy Hospital in Minneapolis, presented the two-year results of ORBIT II at the Society for Cardiovascular Angiography and Interventions 2015 scientific sessions in San Diego.
Related: SCAI 2015: Orbital Atherectomy Treatment of Severely Calcified Coronary Lesions (SCAI)
Questions Linger for Orbital Atherectomy in Calcified Lesions: ORBIT II (Medscape)
Radial PCI in STEMI Can Be Learned Quickly
Operators become proficient in using the radial artery to implant a stent in STEMI patients after approximately 30 to 40 cases, according to a new review.
"The bottom line is that the learning curve is not as long as people might fear," lead investigator Akshay Bagai, MD, told heartwire from Medscape.
Multidisciplinary Approach May Improve Outcomes for Patients With Pulmonary Embolism
Use of a pulmonary embolism response service comprised of cardiologists, cardiothoracic surgeons, pulmonologists and radiologists for the care of high-risk patients with pulmonary embolism was associated with improved diagnosis and treatment, researchers reported at the SCAI Scientific Sessions. A 24-hour multispecialty pulmonary embolism response service surgeons was established at Emory University Hospital Midtown to improve outcomes in this patient population.
SCAI.15: In Practice, Prasugrel Use May Not Mimic Trials
Cardiologists in real-world practice may not be optimizing the benefit of prasugrel in patients undergoing PCI but they also don't appear to be putting them in harm's way, according to results released May 8 at the SCAI 2015 Scientific Sessions in San Diego.
"The therapeutic benefit is more modest in terms of reducing [thrombotic risk] compared to what we have seen in randomized data," said Usman Baber, MD, MS, an assistant professor of cardiology at Mount Sinai Hospital in New York, at a press briefing for late-breaking clinical trials.
Related: Real-World Prasugrel Use Relegated to 'Healthiest' of ACS Patients (Medscape)
New Cause Discovered for Arterial Stiffness, a Contributor to Cardiovascular Disease
Increased vascular stiffness has been identified as an important part of hypertension in aging adults. Previous studies of aortic stiffness have focused on changes in structural proteins that alter the properties of vascular walls causing them to become rigid.
Cardiovascular Risk Factors Extremely High in People With Psychosis
King's College London via Medical Xpress
Extremely high levels of cardiovascular risk factors have been found in people with established psychosis, with central obesity evident in over 80 percent of participants, in a study by researchers from the NIHR Biomedical Research Center at the South London and Maudsley NHS Foundation Trust and King's College London.
In the largest study of its kind in the U.K., drawing on a sample of more than 400 outpatients with psychosis, it was discovered that nearly half of the sample were obese, with a body mass index of 30 or more.
Newer Antiplatelet is Faster in Ad Hoc PCI
Ticagrelor (Brilinta) dropped platelet reactivity lower sooner when given on the table for patients going directly to revascularization after diagnostic angiography, a pharmacodynamics study affirmed. Platelet reactivity dropped further in the first two hours after dosing at the start of percutaneous coronary intervention with a standard 180 milligram dose of ticagrelor (Brilinta) than with 600 milligrams of clopidogrel, Roxana Mehran, MD, of Mount Sinai Hospital in New York City and colleagues found.
Related: SCAI 2015: Ticagrelor vs. Clopidogrel in Troponin-Negative Patients (SCAI)
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The news summaries appearing in SCAI This Week are based on original information from news organizations and are produced by Multibriefs, an independent e-mail newsletter publisher. SCAI is not responsible for the content of sites external to SCAI, nor do reports in SCAI This Week constitute the official opinion of SCAI.
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