TCTMD’s Top 10 Most Popular Stories for August 2023

This month’s list is dominated by the annual European Society of Cardiology (ESC) Congress, where TCTMD journalists gathered all the late-breaking news in stories that captured the gut reactions to the data as well as predictions on what’s next. In the top slot were results from ECLS-SHOCK that raise questions about the utility of mechanical circulatory support in acute MI complicated by cardiogenic shock (AMICS). Other ESC-related articles looked at complete revascularization in the elderly, post-PCI aspirin, long-awaited trials on intravascular imaging, semaglutide in heart failure with preserved ejection fraction (HFpEF), edoxaban in atrial high-rate episodes, a win for warfarin, and traditional Chinese medicine.

But there was one notable outlier in our top 10 that didn’t involve the ESC Congress—not just one but two US Food and Drug Administration advisory panels that considered renal denervation. Takeaways were mixed over the course of those discussions, as L.A. McKeown reported in her comprehensive coverage. One panel gave a thumbs up, while the other wasn’t swayed.

1. ESC Routine ECMO in AMICS Patients Not Protective: ECLS-SHOCK

With no gain in 30-day survival and no signs of subgroups that benefit, clinicians may need to rethink mechanical support.

2. ESC FIRE: Complete Revascularization Best Even for Elderly Patients With MI

Complete PCI guided by functional testing was safe and reduced hard outcomes, including death and MI, in the 75-plus set.

3. ESC STOPDAPT-3: Don’t Skip Out on Aspirin Immediately After PCI

The findings should make clinicians cautious about going without aspirin right away, Manesh Patel says.

4. Medtronic’s Renal Denervation System Fails to Sway FDA Advisory Panel 

With one study positive and another negative, the panel felt too conflicted on effectiveness and risk versus benefits to patients.           

5. ESC Four Intravascular Imaging Studies Shared the ESC Spotlight, Yet Shadows Persist

Many hoped ILUMIEN IV and OCTOBER, plus an updated meta-analysis, would answer some questions. Instead they raised more.

6. ESC STEP-HFpEF: Semaglutide Cuts Weight and Symptoms, Boosts Function

The benefits come amid positive shifts for CRP and NT-proBNP, suggesting more than weight loss is at play, the PI says.

7. ESC NOAH-AFNET 6: Edoxaban for Atrial High-Rate Episodes: No Help, Some Harm

The randomized trial results indicate that these device-detected events should not be treated broadly with anticoagulation.

8. ESC FRAIL-AF: Warfarin Beats NOACs in Frail Elderly With AF

In a surprise, for this population excluded from prior RCTs, switching from the VKA to a NOAC led to more bleeding.

9. ReCor’s Renal Denervation System Gets Thumbs Up From FDA Advisory Panel

The panel voted overwhelmingly in favor of safety, but quibbled about efficacy, durability, and benefits versus risk.

10. ESC Qiliqiangxin, a Traditional Chinese Medication, Cuts CV Events in HF: QUEST

The study merges Chinese and Western medicines, the PI says, noting patients were well treated with triple-therapy HF drugs.

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You can find all of our ESC news and videos here, and for highlights from the meeting, tune into the latest Heart Sounds podcast with TCTMD Managing Editor Shelley Wood and ESC President Franz Weidinger.