Poll Results: End of Year Trial Roundup: Ranking the Top 10

This poll had interesting results. Despite the great interest in structural intervention, the respondents identified coronary intervention issues as the top four most important. The first structural pick, ranked fifth, was COAPT, which possibly reflects the growing interest in mitral valve procedures. The only other structural result was ranked seventh, PARTNER 3. The remainder of selections, ranked sixth through tenth, were two comparative trials of surgery versus percutaneous intervention (PCI) (EXCEL and SYNTAXES). Also in the lower half were the National Cardiogenic Shock Initiative Update and the Society for Cardiovascular Angiography and Interventions Clinical Expert Consensus Statement on the Classification of Cardiogenic Shock. I've framed these as important, but I wonder if part of the order of the choices may reflect the maturity of the science, with the studies relating to PCI being more impactful on longstanding clinical practice management. Thus, ISCHEMIA, with years of discussion, and COMPLETE, relating to revascularization of an ST-segment elevation myocardial infarction were ranged highest, followed by TWILIGHT and AUGUSTUS ACS, again representing the highly complex issues of antiplatelet treatment post-PCI aimed at preserving stent results while minimizing bleeding risk in high-risk patient populations.

Thanks to all who participated.

  1. ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches)
  2. COMPLETE (Complete Versus Culprit-Only Revascularization Strategies to Treat Multivessel Disease After Early PCI for STEMI)
  3. TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention)
  4. AUGUSTUS ACS (A 2x2 Factorial Randomized Trial of Apixaban vs. Warfarin and Aspirin vs. Placebo in Patients With Atrial Fibrillation and an Acute Coronary Syndrome)
  5. COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation)
  6. EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization)
  7. PARTNER 3 (Placement of Aortic Transcatheter Valves 3)
  8. SYNTAXES (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery Extended Survival Study)
  9. National Cardiogenic Shock Initiative Update
  10. Society for Cardiovascular Angiography and Interventions Clinical Expert Consensus Statement on the Classification of Cardiogenic Shock

Keywords: Angiography, Coronary Angiography


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