Live from TCT

Justine Cadet, News Editor

The news from this year’s Transcatheter Cardiovascular Therapeutics (TCT) conference in Washington, D.C., revealed the truth in the words of Jonathan Swift to the interventional community: There is nothing constant in this world but inconsistency.

Dr. Martin B. Leon, chairman emeritus of the Cardiovascular Research Foundation (CRF), which sponsors TCT, reported that the utilization of DES has experienced a 1.3 percent increase for PCI this year in the Drug-Eluting Stent (DES) Summit. This may represent a “soft rebound” from the 10 percent drop that stenting endured in 2007. However, he also noted that the CABG experienced 22 percent increase for 2008. Based on these figures, physicians are slowly beginning to readopt PCI as a treatment option, but are still hesitant about widespread utilization.

The initial results of the Boston Scientific SYNTAX study, which were presented at the European Society of Cardiology (ESC), indicated that CABG was preferable to stenting in the sickest patient populations. However, new subgroup analysis from SYNTAX presented this week showed equivalent safety and efficacy endpoints between PCI and CABG amongst patients with unprotected left main disease, and showed improved efficacy outcomes in triple-vessel disease.

On a truly positive note for DES, the one-year HORIZONS AMI results found that the use of a DES in patients can significantly reduce rates of target lesion revascularization and binary angiographic restenosis when compared to bare metal stents. The impact of this trial is fueled by the large number of enrollees: 3,602 STEMI patients in 11 countries.

However, in a disturbing real-life analysis, JAMA researchers revealed Wednesday that Medicare recipients who undergo elective PCI often do not receive the recommended stress tests to confirm that angioplasty is warranted.

While the 10,000 attendees of TCT heard many studies and presentations employing the best practices in interventional cardiology, the communication of these methods remains integral for those treatment options to be employed in the practical setting.

Please look for continued TCT news in next week’s newsletter.

On these topics, or any others, please feel free to contact me.

Justine Cadet, News Editor
jcadet@cardiovascularbusiness.com