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Utility and Challenges of an Early Invasive Strategy in Patients Resuscitated From Out-of-Hospital Cardiac Arrest Prasugrel versus clopidogrel in patients with acute coronary syndromes Effect of Pre-Hospital Crushed Prasugrel Tablets in Patients with STEMI Planned for Primary Percutaneous Coronary Intervention: The Randomized COMPARE CRUSH Trial Overall and Cause-Specific Mortality in Randomized Clinical Trials Comparing Percutaneous Interventions With Coronary Bypass Surgery: A Meta-analysis 10-Year Coronary Heart Disease Risk Prediction Using Coronary Artery Calcium and Traditional Risk Factors: Derivation in the MESA (Multi-Ethnic Study of Atherosclerosis) With Validation in the HNR (Heinz Nixdorf Recall) Study and the DHS (Dallas Heart Study) Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction: The ARTEMIS Randomized Clinical Trial Update in the Percutaneous Management of Coronary Chronic Total Occlusions Transcatheter Laceration of Aortic Leaflets to Prevent Coronary Obstruction During Transcatheter Aortic Valve Replacement: Concept to First-in-Human Complete or Culprit-Only Revascularization for Patients With Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Pairwise and Network Meta-Analysis of Randomized Trials Percutaneous Coronary Intervention Readmissions Where Are the Solutions?
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Editorial2020 Apr 6;S0828-282X(20)30316-0.

JOURNAL：Can J Cardiol. Article Link

Precision Medicine in TAVR: How to Select the Right Device for the Right Patient

G Marquis-Gravel, S Vemulapalli, AW Asgar et al. Keywords: patient selection; TAVR

ABSTRACT

Transcatheter aortic valve replacement (TAVR) represents a first-line option for the treatment of patients with severe symptomatic aortic stenosis across the entire spectrum of surgical risks. Given the expected growth of TAVR procedures in low-risk patients, many factors other than the primary endpoints of pivotal TAVR trials (either death, or the composite of death or stroke) need to be considered during the selection of a treatment strategy. Such factors include the risk of procedural complications (permanent pacemaker implantation, stroke, new-onset atrial fibrillation, vascular complications, etc), device hemodynamic performance and durability (paravalvular leak [PVL], reinterventions), indication for antithrombotic therapy, and patient quality of life. The pivotal TAVR trials have indicated that some complications with TAVR vs surgical aortic valve replacement (SAVR) vary according to the device under study. For example, rates of permanent pacemaker implantation were higher with TAVR vs SAVR in trials evaluating self-expanding valves, but not in the those evaluating balloon-expandable valves. TAVR represents a suitable option for all risk groups, but how do we personalise care and select the most appropriate device for our patients?
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