TCTMD’s Top 10 Most Popular Stories for January 2016

Bioresorbable stents, mechanical thrombectomy, and the optimal timing of PCI in non-ST elevation MI were some of the most popular topics on TCTMD last month. But device-driven studies were by no means the only subjects of interest. Other top-clicked stories indicate that the thornier themes of physician leadership, missing patient information, industry payments, and bias in clinical studies also piqued readers’ interest. Several TCTMD feature stories, including a primer on PCSK9 inhibitors, as well as my deep dive into the “open science” initiative, also made the cut. 

In case you missed them, here are the most popular stories on TCTMD for January 2016.

Increased Early Risk of Stent Thrombosis With the Absorb Bioresorbable Scaffold 
For some, dissolving coronary stents represent one of the most promising technologies in interventional cardiology. In recent months, however, multiple reports examining the performance of the leading bioresorbable scaffold suggest that while the device performs as well as a permanent metallic stent clinically, it carries an increased risk of stent thrombosis. 

Possible Turf War Brewing Over Delivery of Acute Stroke Interventions 
Positive results using mechanical thrombectomy with stent retrievers for acute ischemic stroke flooded in this year, marking a “watershed moment in the field,” according to 1 expert. But while that’s great news for patients needing urgent care, it poses major questions for clinicians—namely, who will deliver the interventions and where? 

 Early Invasive Intervention Trumps Delayed Approach in NSTEMI Patients 
Previous studies have tested an early- vs delayed-invasive approach in this setting before, but there is often a failure to discriminate among the different types of NSTE-ACS patients. Now, a small study looking specifically at this group offers some insights. 

 Walking the Plank: New Team-Based Leadership Models in Medicine Supplant ‘Captain of the Ship’ Mentality 
As contemporary healthcare systems have become more complex, caregivers from all specialties have found themselves involved in a “complicated dance of overlapping team-based care activities” that negate the “captain of the ship” philosophy from a bygone era.

 Bioresorbable Scaffolds MayHave Role in Spontaneous Coronary Artery Dissections 
SCAD patients, while rare, tend to be younger with minimal atherosclerotic disease. As such they may have more to gain from the disappearance of the scaffolds after 2 to 3 years, although there are limitations to the technology. 

 Former FDA Staffer Says Missing Data Across Antithrombotic Trials Cast Doubt on Drug Effects 
“Missingness” is increasingly on the radar of the experts charged with reviewing drugs and devices for approval. A new analysis says published rates of “lost to follow-up” across a host of oral antithrombotic drug trials are far lower than the gaps recently found in an FDA review.

 Cardiologists Stand Out for Their Ties to Industry in US Government Database 
Not all cardiologists receive payments from industry, but they are more likely to do so than physicians belonging to any other specialty, according to an analysis of 2013 numbers from the CMS Open Payments program, an off-shoot of the 2010 “Sunshine Act.” 

 Renal Denervation Trials Have Largely Fallen Victim to Unintentional Bias 
Trial designs more resistant to bias—namely, blinded and sham-controlled—will report substantially smaller blood pressure reductions, a new analysis reveals. Thus, unblinded renal denervation studies may have squandered time and resources, 1 researcher argues. 

 PCSK9Inhibitors: Good Early Responses With Pricey Drugs, but Doctors Still Waitingon Real Data 
Seductive early trial results showed massive reductions in LDL cholesterol among patients who took PCSK9 inhibitors, including those already taking high-intensity statin therapy. Now that they are on the market, physicians are coming to terms with when and how to use these pricey drugs.

 The Gift of Data: MedicalJournals Back Public Data Disclosure as Prerequisite for Publishing
The International Committee of Medical Journal Editors (ICMJE) had plans to require clinical trialists to share their data publically as a prerequisite for publishing. That proposal has some celebrating a research opportunity windfall while others are sounding the alarm.