THE BE T
Multimedia Highlights
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ALBATROSS: Aldosterone Blockade in
Myocardial Infarction
Clinical Validation of BARC Criteria in
ACS Patients
Gilles Montalescot, MD: “This class of drugs is extremely effective in HF (and probably outside of HF
as well) and in STEMI patients, but we need more
data. We may get more data with a new generation
of drugs. They will be developed in HF first, and
MI would come later. It is unfortunate, but we will
have to wait, and it will be more expensive. So we
have to wait for further development with the new
drugs unless some government wants to pay for a
new study. This study was paid for by the French
government.”
Pierluigi Tricoci, MD, PhD: “If you look at literature
of the trial, there are several categories and classes
of bleeding. […] There is not a consistent use of a
single scale across the trials. That makes it difficult
to compare results across trials. So, [ it is difficult] if
you want to pull data together for a meta-analysis
simply comparing the rate of bleeding across trials
because the way “bleeding” is defined in each trial
is not the same.”
Beygui F, Cayla G, Roule V, et al. J Am
Coll Cardiol. 2016;67:1917-27.
Vranckx P, White HD, Huang Z, et al.
J Am Coll Cardiol. 2016;67:2135-44.
Gomberg-Maitland M, Shah SJ, Guazzi
M. JCHF. 2016;4:325-8.
Sonothrombolysis: Ultrasound Impulses
and Enhanced Myocardial Perfusion
in PCI
The Wild, Wild Vest: Science Advisory
Tackles Wearable Defibrillator
Multicenter Registry Provides Insight
into Valve Thrombosis and Deterioration After TAVR
Thomas R. Porter, MD: “[Ultrasound] impulses not
only restore the blood flow clogged up with the
blood clot, but downstream from there—what we
refer to as the microvasculature, which is where a
lot of this blood kind of ‘showers’ down into that
area and blocks those tiny little capillaries that
provide the nutrients to the heart. If we don’t get
those blood clots taken care of as well, it doesn’t
matter what we do to the large vessel, we will still
get a big scare there.”
Jonathan Piccini, MD: “The American Heart Association—particularly the Electrocardiography and
Arrhythmias Committee within the Clinical Cardiology Council—recognized that [defibrillators] are
being used frequently in clinical practice, yet there
are no guidance documents from any of the professional societies. So this science advisory was commissioned for several purposes, including provider
education, education of the public, [and] providing
a framework for where there are unmet needs in
the research infrastructure.”
Mathias W, Jr., Tsutsui JM, Tavares BG,
et al. J Am Coll Cardiol. 2016;67:2506-15.
Piccini J, Allen L, Kudenchuk P, et al.
Circulation. 2016;133:1715-27.
10
CardioSource WorldNews
Inflammation in Heart Failure with
Preserved Ejection Fraction: Time to
Put Out the Fire?
Sanjiv Shah, MD: “First of all, the comorbidities
are so common with heart failure with preserved
[ejection fracture], and that’s one of the things we
focused on for year. In fact, several years ago in
JAMA, we wrote an editorial basically saying, ‘Sure
there are no treatments for the syndrome right
now, but you can treat now by treating the comorbidities, because comorbidities are so common in
this syndrome.’ Now, we think that the syndrome
with preserved EF is beyond comorbidities.”
Josep Rodés-Cabau, MD: “We decided to this
paper because I think that one of the important
aspects of this field is to try to understand whether
or not there is some valve deterioration. We are
talking more and more about valve durability, and
we are talking more and more about the potential
of valve thromobisis in some instances. So we
thought about the significant number of patients
with serial follow-up echocardiographies whether
or not to detect any valve deterioration in these patients.”
Del Trigo M, Muñoz-Garcia AJ, Wijeysundera HC, et al. J Am Coll Cardiol.
2016;67:644-55.
June 2016