Transcatheter therapies and drug-eluting balloons are hot topics at TCT

Twitter icon
Facebook icon
LinkedIn icon
e-mail icon
Google icon
Gregg W. Stone, MD, Director of Cardiovascular Research at New York-Presbyterian Hospital/Columbia Medical Center in New York City

As the 23rd annual scientific symposium of the Transcatheter Cardiovascular Therapeutics (TCT) meeting kicks off Nov. 7, in San Francisco, attendees can expect the hubbub to center on transcatheter valve therapies, stent compression and drug-eluting balloons. Gregg W. Stone, MD, highlighted some of the hot topics that will be featured at this year’s meeting.

Stone, director of TCT and director of Cardiovascular Research and Education at Columbia University Medical Center/New York-Presbyterian Hospital in New York City, said that attendees can expect to see an “unprecedentedly high attendance rate,” up 1,000 to 2,000 more than the 12,000 recorded at last year’s meeting. With nearly 100 countries represented, meeting content will cover a breadth of materials, including coronary and endovascular interventions, as well as peripheral interventions, among others.

The late-breaking clinical trials—always the meeting’s attention grabbers—begin Wednesday, Nov. 9.

The late-breaking clinical trials presented Wednesday, Nov. 9, will focus on both PCI pharmacology and stent thrombosis:

  • ADAPT-DES: A large-scale, prospective, multicenter registry examining the relationship of platelet responsiveness to stent thrombosis after DES implantation.
  • DESERT: A large-scale, multicenter case-controlled study examining the predictors of stent thrombosis.
  • PARIS: A large-scale, prospective, multicenter registry studying the patterns of and reasons for nonadherence to antiplatelet agents in stented patients.
  • RAPID GENE: A prospective, randomized trial of prasugrel (Effient, Eli Lilly/Daiichi-Sankyo) versus clopidogrel (Plavix, Bristol-Myers Squibb, Sanofi Aventis) in CYP2C19*2 carriers identified by rapid point-of-care genotyping. Stone said that this is the first study to look at point-of-care testing to assess risk of stent thrombosis and clopidogrel response, which could be done right at the bedside.
  • TRIGGER-PCI: A prospective, randomized trial of prasugrel versus clopidogrel in clopidogrel hyporesponsive patients with stable ischemic heart disease undergoing percutaneous coronary intervention.
  • BRIDGE: A prospective, double-blind, multicenter, randomized placebo-controlled trial of intravenous cangrelor in patients awaiting surgery.

The late-breakers presented Thursday, Nov. 10, will focus both on transcatheter aortic valve replacement and primary PCI in STEMI:

  • PARTNER Cohort B: Two-year data from the previously reported PARTNER B trial, a prospective, randomized trial evaluating transcatheter aortic valve replacement versus standard therapy in patients with inoperable aortic stenosis, will be reported. “The marked benefits seen at one-year were in a very elderly, high-risk population, but whether these advantages are maintained over a longer duration of follow-up will become important,” Stone offered.
  • PARTNER Cohort A: These data will provide a cost and quality of life assessment from the prospective, randomized PARTNER cohort A trial, which evaluated transcatheter aortic valve replacement therapies versus surgical aortic valve replacement in patients at a high-risk for surgery, who also have aortic stenosis. “Cohort A showed noninferiority, so understanding the quality of life and cost-effective of these two strategies is important, especially when the clinician is deciding to choose between the two,” Stone says.
  • STACCATO: A small, prospective, randomized trial of transapical transcatheter aortic valve replacement vs. surgical aortic valve reaplcement in low-surgical-risk elderly patients with aortic stenosis. “This is the first trial of its kind to look at transapical aortic valve replacement vs. surgical aortic valve replacement in patients at a low-risk. This is the lowest risk population studied in a trial,” Stone said.
  • RIFLE STEACS: A prospective, randomized trial of radial vs. femoral vascular access in patients with STEMI.
  • MUSTELA: A prospective, randomized trial of thrombectomy vs. no thrombectomy in patients with STEMI and thrombus-rich lesions.
  • DEB-AMI: A prospective, randomized trial of paclitaxel-coated balloons plus bare-metal stents versus paclitaxel-eluting stents versus BMS-alone in patients with STEMI.

The late-breaking clinical trials presented on Friday, Nov. 11, will focus on novel drug-eluting stents (DES) and drug-coated balloons, as well as optimal