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Clinical impact of PCSK9 inhibitor on stabilization and regression of lipid-rich coronary plaques: a near-infrared spectroscopy study Comparison of safety and periprocedural complications of transfemoral aortic valve replacement under local anaesthesia: minimalist versus complete Heart Team Coronary Access After TAVR Impaired Retinal Microvascular Function Predicts Long-Term Adverse Events in Patients with Cardiovascular Disease Usefulness of minimum stent cross sectional area as a predictor of angiographic restenosis after primary percutaneous coronary intervention in acute myocardial infarction (from the HORIZONS-AMI Trial IVUS substudy) Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication From Detecting the Vulnerable Plaque to Managing the Vulnerable Patient Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions Clinical Impact of Valvular Heart Disease in Elderly Patients Admitted for Acute Coronary Syndrome: Insights From the Elderly-ACS 2 Study Delirium After TAVR: Crosspassing the Limit of Resilience

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.