Several of the late-breaking clinical trials presented at the 29th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium in Denver next week are sure to generate significant interest in the cardiology community. Some could even change practice, according to experts in the field.
Robert W. Yeh, MD, decided to start the conversation sooner. He selected four of the most highly anticipated trials on the docket and asked respondents on Twitter which one they were most excited about.
CULPRIT-SHOCK, a randomized comparison of multivessel versus culprit-lesion PCI in the setting of cardiogenic shock, drew 48 percent of the 172 votes, followed by ORBITA (30 percent), ABSORB IV bioresorbable stent 30-day data (11 percent) and quality-of-life data from the PARTNER trial analyzing transcatheter aortic valve replacement versus surgical valve replacement (11 percent).
“I think people have been really looking forward to CULPRIT-SHOCK for a long time,” said Yeh, director of the Smith Center for Outcomes Research in Cardiology at the Beth Israel Deaconess Medical Center in Boston. “It’s a highly relevant clinical question and it’s hard to do a trial in that space. … It’s been on everyone’s radar and it could potentially change practice. It’s no surprise to me that CULPRIT-SHOCK was the first and foremost of interest.”
Likewise, Yeh wasn’t surprised to see ORBITA generate a significant number of votes. The first double-blinded, sham-controlled trial of PCI versus optimum medical therapy will be powered to show differences in quality of life and exercise duration. It could address the question of whether a placebo effect is present in PCI.
“ORBITA is sort of a David among Goliaths in the trial space,” Yeh said. “It’s a small, investigator-initiated, highly physiologic, very carefully done study, but has 200 patients. Usually 200 patients won’t gather as much traction at a big conference where there are 5,000-person trials being presented, but ORBITA is a very unique study in a lot of ways. … A sham-controlled trial in this space is something that, I think, people had been previously unwilling to do and potentially, depending on how things look, could change how we think about PCI. So, I think there’s a lot of strong interest there.”