TCTMD’s Top 10 Most Popular Stories for January 2020

News that coconut oil drives up LDL cholesterol was far and away our most-read story in January, followed by a discussion of FFR in the post-ISCHEMIA era led by Morton Kern, MD. A controversial TAVR session from the Society of Thoracic Surgeons (STS) 2020 conference also made the list, as did a proposal to rethink how stent overuse is criminalized, the high price of tafamidis (Vyndamax and Vyndaqel; Pfizer), and a new paclitaxel device meta-analysis—this time below-the-knee.

1. Coconut Oil Ups LDL Cholesterol Compared With Other Fats: Meta-analysis

Despite popular belief, coconut oil has no anti-inflammatory or glycemic benefits, leading experts to discourage its consumption.

2. Conversations in Cardiology: In the ISCHEMIA Era, What Role for FFR?

Morton Kern, MD, often engages his colleagues via email in brief, informal dialogue on clinically relevant topics in cardiology.

3. Criminalizing Stent Cases? The 70/30 Rule Must Go, Experts Say

Unnecessary stenting does happen, but proving that it’s fraud needs an overhaul, say the authors of a Circulation perspective.

4. TAVR Tussle at US Surgery Meeting Threatens to Widen Surgeon-Cardiologist Wedge

Physicians had a range of reactions to TAVR trial criticisms, but STS leaders say they stand for balanced discourse.

5. ‘Outrageous’ $225,000 per Year List Price for Tafamidis Draws Outcry

Pfizer is “gouging” payers, say researchers, noting that elderly patients have out-of-pocket costs of $1,000 to $2,000 a month.

6. Paclitaxel DCBs Now Implicated in Death, Amputation in Below-the-Knee CLI

The new meta-analysis is unlikely to have the same explosive impact as a 2018 study in femoropopliteal patients, experts say.

7. MitraClip in the US: As Coverage Update Looms, Some Questions for REPAIR MR

A functional mitral regurgitation fix with the MitraClip (Abbott) is expected to get Centers for Medicare & Medicaid backing, just as a new trial in degenerative disease moves ahead.

8. Revascularization After PCI or CABG Linked to Higher Mortality: EXCEL

Revascularization was more frequent with PCI, and only target-lesion or target-vessel redos were tied to mortality.

9. Fluoroless Cath Promises Less Radiation, but the Tech Is Still Early

Fiber optics can create images that aid in device navigation. Experts at the 2020 International Symposium on Endovascular Therapy stressed the need for more study.

10. CV Safety Trial for Lorcaserin Picks Up Cancer Signal: FDA

CAMELLIA-TIMI 61 showed no sign of higher CV events with the obesity drug back in 2018, but a cancer signal has since emerged.