The research area that rose to the top in terms of importance to practice at the upcoming Transcatheter Cardiovascular Therapeutics meeting in San Diego is in mitral valve interventions, but there’s much more potentially practice-changing original reporting as well.
Dr. Juan Granada
Of the 155 abstracts considered for Late-Breaking Trials, only 10% were selected. That’s in addition to the other 1,650 abstracts submitted for the meeting.
The research chosen for the Late-Breaking Trial and Late-Breaking Research sessions held on Saturday, Sept. 22, through Tuesday, Sept. 25, fall into four categories, Juan F. Granada, MD, president and CEO of the Cardiovascular Research Foundation and codirector of Transcatheter Cardiovascular Therapeutics, said in an interview.
The first and most important category is mitral intervention, he said, and the studies with the most potential to change U.S. practice will be presented on Sunday morning at 10:15-11:15 in the Late-Breaking Trial session. The session kicks off with COAPT, the long-anticipated trial that randomized patients with severe mitral regurgitation secondary to heart failure to the MitraClip or to optimal medical management. The MitraClip, which doesn’t entail a concomitant annuloplasty, currently is approved by the Food and Drug Administration for patients with primary, degenerative mitral regurgitation not amenable to surgical repair only. But, if COAPT yields positive results, the role of the MitraClip may expand greatly.
Also presented in that Sunday session will be results of REDUCE-FMR, a sham-controlled trial in patients with heart failure–associated functional mitral regurgitation who received either treatment with the CARILLON Mitral Contour System, which is an indirect annuloplasty device, or optimal medical treatment.
Secondly, “we’ve got a lot to learn from two trials in the Absorb bioresorbable scaffold,” Dr. Granada said. Although the device failed commercially on the heels of news of target vessel failure and scaffold thrombosis, detailed results of ABSORB IV and COMPARE ABSORB will inform future designs, he said.The third area Dr. Granada emphasized was direct comparisons of stents. Saturday’s Late-Breaking Trials sessions offer results of several head-to-head trials. BIONYX compared the bioresorbable polymer Orsiro stent with the newer durable polymer Resolute Onyx. TALENT, unusual in its all-comers design, compared clinical outcomes at 12 months between the Supraflex ultrathin coronary stent and Xience everolimus eluting system. Whether strut thickness can make a difference in outcomes will be of great interest as the results of these and other trials are presented at the meeting.
Lastly, an endovascular trial comparing two stents in long lesion, IMPERIAL, will be of interest. It randomized patients with chronic, symptomatic superficial femoral or proximal popliteal artery lesions to treatment with either the Eluvia vascular stent or the Zilver PTX, the first drug-eluting stent approved for use in these patients.
Remember, there also are oral abstract and moderated poster sessions happening throughout the meeting, so there’s something for everyone.