Several abstracts presented this week at TCT 2025 share meaningful insights derived from NCDR data – specifically ACC's CathPCI Registry and the STS/ACC TVT Registry. View key findings summarized below.

CathPCI Registry

Contemporary Trends For the Treatment of ISR in the US: Looking at 1,182,599 in-stent restenosis (ISR) patients, Jennifer Rymer, MD, FACC, et al., found more than 14% of ISR PCIs were for recurrent ISR. The authors also saw a significant increase in the use of "more aggressive" devices to treat ISR from 2018 to 2024. They note that ISR patients treated with more aggressive devices were more likely to suffer from in-hospital mortality or myocardial infarction than patients treated with standard therapy.

National Prevalence, Temporal Trends and Predictors of SDD Post PCI For NSTE-ACS in Clinical Practice: According to Johanna Lerner, MD, et al., same day discharge (SDD) after non-ST elevation acute coronary syndrome (NSTE-ACS) is rare but has increased from 2018 to 2024. Reviewing 1,325,771 PCIs from the registry, the authors found that radial access was the strongest predictor of SDD in this patient population and significant variability among hospitals.

STS/ACC TVT Registry

Aspirin vs. Clopidogrel Following TAVR: A TVT Propensity Matched Analysis: Yuri B. Pride, MD, FACC, et al., found no difference in major adverse cardiovascular events and a significantly higher likelihood of major bleeding in uncomplicated transfemoral TAVR patients prescribed clopidogrel vs. aspirin monotherapy. Their analysis included 35,438 patients undergoing TAVR between Jan. 1, 2021 and Jan. 31, 2023.

Impact of Access Route on TAVR in Patients With Moderate to Severe Obesity and Low and Intermediate Surgical Risk: Comparing transfemoral access and alternative access in TAVR patients with low and intermediate risk and moderate to severe obesity, Mansi Maini, MD, MSc, et al., found that alternative access had a higher risk of stroke and mortality in patients with BMI ≥35; however, in patients with BMI ≥45, alternative access demonstrated vascular safety without added risk of stroke or mortality. The authors state that "procedural planning should integrate BMI along with anatomy and comorbidity."

The Impact of Frailty on Outcomes in Patients Undergoing Mitral TEER: Michael N. Young, MD, FACC, and Amit N. Vora, MD, MPH, FACC, found an association between frailty and greater odds of mortality at 30-days and one-year among patients undergoing mitral transcatheter edge-to-edge repair. When investigating the relationship with heart failure (HF) readmission, objective frailty assessment was associated with the outcome at 30 days, but not at one year.

Trends and Outcomes of Antithrombotic Strategies For Valve-in-Valve TAVR: Hiroki A. Ueyama, MD, et al., found "considerable variation" at the operator and institution level in antithrombotic strategy following valve-in-valve TAVR. Their analysis, including 18,414 patients from 781 sites, found no significant difference in outcomes when comparing patients with single antiplatelet therapy, dual antiplatelet therapy and oral anticoagulation, but they acknowledge "a randomized trial with long-term follow-up is necessary to guide clinical care in this growing patient population."

MV Gradient and Long-Term Outcomes Following Mitral TEER in Patients With Severe MR: Arman Qamar, MBBS, MD, FACC, et al., explored the association between post-repair mitral valve gradient (MVG) and long-term outcomes after mitral TEER, including 80,991 patients from the registry. Patients with elevated MVG post mitral TEER exhibited an increased likelihood of mortality and hospitalization for HF, pointing to "the need for innovative procedural strategies to minimize post-procedural MVG."

Explore more live coverage from TCT with ACC's meeting coverage page and social media channels. A full listing of TCT abstracts was published by JACC.

Read more about NCDR research at TCT 2025:

• EVOQUE: STS/ACC TVT Registry Assesses Safety, Effectiveness of TTVR
• TCT 2025 Science Published Across JACC Journals Explores FIRE, EMERGE LAA and More
• AI-Based ECG Analysis Significantly Improves STEMI Detection, Reduces False Activations

Keywords: STS/ACC TVT Registry, National Cardiovascular Data Registries, Transcatheter Cardiovascular Therapeutics, TCT25, CathPCI Registry