• TAVR Reimbursement; Carotid Stenting in the Real World; GLOBAL LEADERS Subgroups

    Interventional cardiology news to note

    Medicare episode payments were roughly 7% lower for transcatheter aortic valve replacement (TAVR) than surgery, with the greatest difference among the sickest patients. TAVR's higher preprocedural payments were offset by lower payments during and after the index hospitalization. (Circulation: Cardiovascular Quality and Outcomes)

    Carotid artery stenting led to an overall 30-day stroke and death rate of 2.0% for patients in the CREST-2 registry. The rates were 2.8% and 1.4% for symptomatic and asymptomatic carotid stenosis, respectively. (Journal of the American College of Cardiology)

    Unlike in the CREST trial, carotid endarterectomy resulted in more perioperative strokes than did carotid artery stenting in a retrospective nationwide study that matched patients by characteristics including illness severity. (Stroke)

    Microvascular and vasospastic angina appear to be distinct disorders that differ in associated clinical characteristics, symptoms, and angina severity in patients with ischemia but no obstructive coronary artery disease, according to a report in Circulation: Cardiovascular Interventions.

    Elderly patients in the GLOBAL LEADERS trial had fewer deaths and MIs in the 2 years after percutaneous coronary intervention (PCI) if they were assigned to 1 month of dual antiplatelet therapy (DAPT) then 23 months of ticagrelor (Brilinta) as opposed to 12 months of DAPT followed by 12 months of aspirin. The ticagrelor monotherapy arm also had a lower rate of stent thrombosis, whereas bleeding was no different between groups. (EuroIntervention)

    In another GLOBAL LEADERS analysis, patients with established cardiovascular disease did not share that reduction in the primary endpoint with ticagrelor monotherapy(Catheterization & Cardiovascular Interventions)

    The leaflet-to-annulus mismatch index, which often correlates with the annular dilation seen commonly in chronic mitral regurgitation (MR), was a predictor of residual MR after MitraClip mitral repair, one center reported. This metric could potentially help identify people who need an annuloplasty before edge-to-edge repair, researchers said. (JACC: Cardiovascular Intervention)

    Source:

    Read the original article on Medpage Today: TAVR Reimbursement; Carotid Stenting in the Real World; GLOBAL LEADERS Subgroups

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