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Prognostic impact of atrial fibrillation in cardiogenic shock complicating acute myocardial infarction: a substudy of the IABP-SHOCK II trial Relationship Between Infarct Size and Outcomes Following Primary PCI: Patient-Level Analysis From 10 Randomized Trials Intravascular ultrasound-guided percutaneous coronary intervention in left main coronary bifurcation lesions: a review Predicting lifetime risk for developing atherosclerotic cardiovascular disease in Chinese population: the China-PAR project Prognostic impact of non-culprit chronic total occlusions in infarct-related cardiogenic shock: results of the randomised IABP-SHOCK II trial Risk of Early Adverse Events After Clopidogrel Discontinuation in Patients Undergoing Short-Term Dual Antiplatelet Therapy: An Individual Participant Data Analysis Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction Non-eligibility for reperfusion therapy in patients presenting with ST-segment elevation myocardial infarction: Contemporary insights from the National Cardiovascular Data Registry (NCDR) Intracoronary Optical Coherence Tomography 2018: Current Status and Future Directions Predicting the 10-Year Risks of Atherosclerotic Cardiovascular Disease in Chinese Population: The China-PAR Project (Prediction for ASCVD Risk in China)

Review Article2019 May 10. doi: 10.1097/HCO.0000000000000638.

JOURNAL:Curr Opin Cardiol. Article Link

Major trials in coronary intervention from 2018

Patel A, Marah N, Balan P et al. Keywords: lesion assessment, novel stent design, acute coronary syndromes; chronic total occlusion intervention

ABSTRACT

PURPOSE OF REVIEWThis article will review the major clinical trials related to coronary intervention that were released in 2018. Areas of interest include lesion assessment, novel stent design, acute coronary syndromes (ACSs), and major breakthroughs in chronic total occlusion interventions.


RECENT FINDINGS -  The benefit of intracoronary imaging and hemodynamic assessment was demonstrated by multiple studies, which found improved procedural and clinical outcomes in patients who underwent advanced assessment of intracoronary lesions. The optimal use of drug-coated balloons in coronary disease still remains unclear with conflicting data regarding the benefit of DCB over everolimus-eluting stents for the treatment of in-stent restenosis. Trials in bioresorbable scaffolds also saw a high level of interest after the ABSORB IV trial showed promising results with changes in implantation technique. Multiple studies evaluated complete revascularization versus infarct-related only revascularization in patients with ACS; however, data was conflicting in regard to what is the best strategy. Lastly, the EUROCTO study was released in 2018 and was the first trial to show symptomatic benefit of revascularization of chronic total occlusions.


SUMMARY -  The ESC/EACTS guidelines on complete versus partial revascularization, treatment of in-stent restenosis, and revascularization during cardiogenic shock were updated to reflect data obtained from trials released in 2018.