1. EuroPCR 2011 research highlights:A slideshow presentation

2. EuroPCR 2011 Research HighlightsEuroPCR 2011 took place in Paris, France, from May 17 through May 20,2011. The conference was attended by 12 567 people.Key trials/topics presented at the conference include:RECLOSE 2-ACS: Poor clopidogrel responders with ACS face twofoldrisk of cardiac deathDISCOVER FLOW: Adding function to CTA with "noninvasive FFR" upsaccuracy, may cut proceduresTAVI spotlight swings to risks of paravalvular leaksRenal denervation: Wider role for procedure considered, amid calls formore studiesBASE-ACS: Could a bare-metal stent be "noninferior" to a leading DES?SOURCE: New numbers from registry bolster PARTNER results in realworldDES meta-analysis: Less stent thrombosis with biodegradable vspermanent polymersSCAAR registry: Transradial PCI cuts mortality in STEMIView our complete EuroPCR coverage here. 3. RECLOSE 2 ACSResponsiveness to Clopidogrel and Stent-Related Eventsin Acute Coronary SyndromesResults: ACS patients identified as being "poorresponders" to a 600-mg loading dose of clopidogrel facea twofold risk of cardiac death in the next few years,results from the RECLOSE 2 ACS study show. Of note,however, doubling the maintenance dose of clopidogrelor shifting patients to ticlopidine did not appear tomitigate this risk over time."This will allow us to narrow the focus of where were goingto be using the more potent agents, because clopidogrelstill has a role," said Dr Dominick Angiolillo (University ofFlorida College of Medicine, Jacksonville)."Even in ACSpatients, there are patients who respond to clopidogrel anddo well."See: Poor clopidogrel responders with ACS face twofoldrisk of cardiac death: RECLOSE 2 ACS 4. DISCOVER FLOW Results: As arguments over the necessity of stent procedures and imaging tests approach a fever pitch, a new computer modeling system that can add functional information to standard coronary computed-tomography (CT) angiography may once again shake up the world of diagnostic imaging and clinical decision making. According to study investigators, the new technique, dubbed noninvasive fractional flow reserve (FFRCT), can dramatically improve the diagnostic accuracy of CT imaging without the need for an invasive test, adenosine, or additional radiation exposure."This noninvasive all-in-one technology may reduce unnecessary invasive coronary angiography and revascularizationprocedures," said Dr Bon-Kwon Koo (Seoul National University Hospital, Korea). "Because this model starts with justconventional CT imaging, there are no [additional] radiation, imaging procedures, or medication. Any CT images, takenfrom any lab, can be transferred to this novel technology."See: Adding function to CTA with "noninvasive FFR" ups accuracy, may cut procedures: DISCOVER FLOW 5. TAVI SpotlightSummary: Paravalvular leaks are extremely rare in surgical aortic-valvereplacement--seen in just 1.5% to 2% of cases. But as experts observed atEuroPCR 2011, mild paravalvular leaks are relatively common intranscatheter aortic-valve implantation (TAVI). New data presented at theconference suggest that more severe paravalvular aortic regurgitation (AR)is a key reason for prosthetic valve dysfunction."Our primary focus initially was actually on device success and procedural success, so people were focusing on implantingthe devices in the correct position and without perivascular complications--the focus was not so much on aorticregurgitation or residual regurgitation," said Dr Peter Wenaweser (Bern University Hospital, Switzerland). "Now we arequite happy about all the device success and the hemodynamic performance as well, so now . . . we are now trying to get abetter understanding of how we can further improve this technology."See: TAVI spotlight swings to risks of paravalvular leaks 6. Renal denervation Summary: Interventional cardiologists gathered at EuroPCR 2011 mulled the potential new applications for renal denervation--the centerpiece of the "live case" presentation that kicked off this years meeting--even as they admitted that the very limited data supporting the procedure in resistant hypertension need to be replicated in larger studies. The speculation on future uses comes as longer-term data from the Symplicity HTN-1 pilot study are published in the May 2011 issue of Hypertension."We have relatively limited numbers of patients who have been included in the trials, yet the potential size of the population whocould benefit is huge," session chair Dr William Wijns (Cardiovascular Center Aalst, Belgium) observed. "Should this mismatchbe addressed by larger trials?"See: Wider role for renal denervation considered, amid calls for more studies 7. BASE-ACS Comparison of Bio-Active-Stent to the Everolimus-Eluting Stent in Acute Coronary Syndrome Results: BASE-ACS, presented during the late-breaking clinical- trials session at EuroPCR 2011, showed the Titan-2 BAS (Hexacath) bare-metal stent to have nearly identical rates of major adverse cardiovascular events (MACE) as the market- leading Xience V (Abbott Vascular) at 12 months, in ACS patients. "The present study suggests that a stent coated with titanium nitride-oxide represents a safe and effective alternative to Xience V everolimus-eluting stents in ACS patients," concluded Dr Pasi Karjalainen (Heart Center, Satakunta Hospital, Pori, Finland). See: BASE-ACS: Could a bare-metal stent be "noninferior" to a leading DES? 8. SOURCE RegistryResults: New numbers from the SOURCE registry,which tracks patients treated with the Sapien valve(Edwards) by either the transapical or transfemoralroute, suggest that the groundbreaking randomizedcontrolled PARTNER trial results are more or less inkeeping with outcomes seen in "real-world" practiceoutside the US. One-year survival for the entirecohort (over 23,000 patients) was 76.5%, climbing to80.1% in the transfemoral group and dipping to74.2% in the transapical group.The registry gives "very good information . . . in real-world terms, in all [the types of] patients coming for this kind of treatment,"said Dr Olaf Wendler (Kings College Hospital, London, UK) . "On the other hand, its not covering all implantations of theSapien valves, and its not covering all the implantations with other devices. In the end, there are no better data than these, butthey cover only one part of the TAVI experience at the moment."See: New SOURCE numbers bolster PARTNER results in real world 9. DES meta-analysis:Biodegradable vs permanent polymers Results: A new meta-analysis with three-year data is offering the first solid proof that drug-eluting stents (DES) with bioerodable polymers are associated with less stent thrombosis and better clinical outcomes than stents with permanent polymers. "The issue to date has been that because late adverse events are very rare, we need large numbers of patients so we can detect any differences," said Dr Robert Byrne (Deutsches Herzzentrum, Munich, Germany. "I think this is probably the first time that weve detected a clear signal toward reduced clinical events. It may be that these differences only start to emerge or we can only tease them out after three years, and earlier time points arent really showing the benefit of these platforms." See: Less stent thrombosis with biodegradable vs permanent polymers: Meta-analysis 10. SCAAR Registry Results: Use of radial PCI in the treatment of STEMI patients in Sweden is associated with a 22% reduction in mortality and lower rates of bleeding and rehospitalizations, a new retrospective analysis of the SCAAR registry suggests. "While the study supports the feasibility and safety of radial for STEMI, it does not contribute to [the question of] the comparison with transfemoral, due to case selection, time-sensitive anticoagulation regimens, and crossover," said Dr Ron Waksman (Washington Hospital, Washington, DC). "Operators should continue to perform PCI with the access that they feel comfortable with, and there is not sufficient evidence from this study to switch to radial from femoral." See: SCAAR registry: Transradial PCI cuts mortality in STEMI 11. For more information EuroPCR EuroPCR 2011 coverage on theheart.org EuroPCR 2011 coverage on Medscape 12. Credits and disclosuresEditor-in-Chief/Journalist:Shelley WoodManaging Editor, heartwireKelowna, BCDisclosure: Shelley Wood has disclosed no relevant financial relationships.Contributor:Steven RourkeManager, Editorial Programmingtheheart.orgMontreal, QCDisclosure: Steven Rourke has disclosed no relevant financial relationships. 13. More slideshowsHRS 2011 research highlightsACC 2011 research highlightsAHA 2010 research highlights: A slideshowpresentationTCT 2010 research highlights: A slideshowpresentation 14. Become a member of http://www.theheart.orgBecome a fan on Facebook: http://www.facebook.com/theheartorgFollow us on Twitter: http://www.twitter.com/theheartorgtheheart.org is the leading online source of independent cardiology news.We are the top provider of news and opinions for over 100 000 physicians.