Dr Kalra, Dr Gogas and the Editorial Board present Volume 14 of US Cardiology Review.
This volume comprises sections: 1) dual antiplatelet therapies after percutaneous coronary interventions (PCI), 2) valvular heart disease in heart failure, and 3) complex coronary interventions as well as a contemporary review article focusing on the cardiovascular implications of COVID-19.
The first section presents insights from the TWILIGHT trial, a large randomized trial that aimed to assess the safety and efficacy of dropping aspirin and retaining antiplatelet monotherapy with ticagrelor compared with standard dual antiplatelet therapy in high bleeding risk patients after PCI. After successful completion of the trial, Mehran et al. discovered that the transition from dual antiplatelet therapy consisting of ticagrelor plus aspirin to ticagrelor-based monotherapy at 3 months resulted in a lower risk of bleeding events without increased risk of death, MI, or stroke. The next section is focused on the adjuvant role of percutaneous edge-to-edge mitral valve repair using the MitraClip device in patients with heart failure who suffer from functional mitral regurgitation, defining patients who benefit most from this interventional treatment.
The focused section reveals the important role of intravascular imaging during complex coronary interventions. Ibrahim et al. unravel the basic principles of intravascular ultrasound (IVUS), further discussing the optimal clinical outcomes achieved during complex interventions when IVUS is leveraged. Zhang et al. deliver insights from all trials that investigated IVUS-guided PCI vs. angiographic guidance concluding that IVUS-guidance leads to optimal long-term clinical outcomes. Technical iterations of standard stenting techniques enable operators to achieve optimal results without additional equipment; Lavarra et al. describe an iteration of the established DK-Crush technique by implementing the proximal side-branch optimization. Finally, Truesdell et al. propose an important algorithm for tackling calcified lesions including all the available devices with FDA regulatory approval.
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