New research was presented at TCT 2015, the Cardiovascular Research Foundation’s Transcatheter Cardiovascular Therapeutics annual meeting, from October 11 to 15 in San Francisco. The features below highlight some of the studies that emerged from the conference.
Estimating Fractional Flow Reserve With CT
The Particulars: Comparisons of diagnostic angiography with fractional flow reserve derived from CT (FFR-CT) in patients with chest pain are lacking.
Data Breakdown: For a study, researchers looked at patients who were either undergoing planned invasive testing with diagnostic angiography or planned noninvasive testing. Participants were assigned to usual care or a strategy guided by FFR-CT. Average costs were 32% lower for patients in the FFR-CT arm than for the invasive testing group. The difference in costs was driven mostly by the lower costs of invasive procedures. In addition, 61% of angiograms were canceled after FFR-CT data were obtained by physicians. Only 12% of patients who underwent angiography following FFR-CT did not have obstructive coronary disease, compared with 73% of those assigned directly to diagnostic angiography.
Take Home Pearl: A diagnostic strategy with FFR-CT among chest pain patients suspected to have coronary artery disease appears to reduce the number of patients requiring invasive diagnostic angiography, resource utilization, and associated costs.
Improving Care With Mitral Valve Teams
The Particulars: Patients with mitral valve disease require complex care from cardiologists and surgeons. A team approach to this care could increase coordination and collaboration.
Data Breakdown: David L. Brown, MD, FACC, FACP, FSCAI, founder of the Heart Hospital Baylor Plano and president and chairman of the medical staff, suggests that cardiologists and surgeons must work together to develop integrated, multidisciplinary teams as a concept embedded in the approach to care for patients with mitral valve disease. These teams, according to Dr. Brown, should focus on preparing for patients’ visits, performing echocardiography and CT, marketing the program, and conducting routine reviews to improve patient care. The mitral valve heart team can serve as a vehicle to provide coordination and collaboration among multidisciplinary practitioners and support staff, Dr. Brown says.
Take Home Pearl: The creator of a mitral valve heart team suggests that such teams must be a concept embedded in the approach to care for patients with mitral valve disease.
Radial Vs Femoral Access for PCI
The Particulars: Results of studies comparing the effectiveness of radial or femoral approached to PCI have been unclear.
Data Breakdown: For a study, patients scheduled for PCI were randomized to a transradial or transfemoral approach. Patients in both groups had similar major adverse cardiac or cerebrovascular event-free rates at 1 year. However, those in the transradial group had significantly fewer major bleeding complications at 1 week after PCI when compared with recipients of the transfemoral approach.
Take Home Pearl: Transradial approaches to PCI appear to be as effective as the transfemoral approaches and are associated with a lower incidence of bleeding.
For more information on these studies and others that were presented at TCT 2015, go to www.crf.org/tct.