ACC for the Cath Lab: PARTNER II, Delayed DES, Early Beta-Blockers

The American College of Cardiology (ACC) scientific sessions roll into Chicago this weekend bringing the findings of 24 late-breaking trials and a slew of other highlighted clinical research studies.

For interventional cardiologists, the action starts with PARTNER II in the Saturday morning opening showcase. The trial pits TAVR against surgery for reducing death or stroke for an intermediate surgical risk group. With a follow-up of 2 years, these results will show whether TAVR outcomes in these patients are similar to their high-risk counterparts.

Also in the spotlight are the following trials:

DANAMI-3: Can deferring drug-eluting stent implantation after primary percutaneous coronary intervention (PCI) lower the odds of stent thrombosis in ST-segment elevation myocardial infarction (STEMI) patients? Does postconditioning reduce infarct size in this group? Two presentations from a randomized Danish study attempt to answer these questions.

Early-BAMI: This randomized, double-blind trial will be noteworthy for its data on the impact of early IV beta-blocker treatment before PCI on infarct size for STEMI patients.

Sapien 3: Next-generation TAVR using the Sapien 3 prosthetic goes head to head with PARTNER II Cohort A patients who got surgery. At 1 year, it will be seen if these propensity-matched results match the promising 30-day findings -- in which the Sapien 3 boasted very low adverse event rates -- that were presented at ACC 2015.

FIRE AND ICE: This prospective study comparing cryoballoon and irrigated radiofrequency ablation for paroxysmal atrial fibrillation holds promise for finally pinning down the optimal ablation technology.

INOVATE-HF: Do patients with heart failure benefit from vagal nerve stimulation? Data from this study come 2 years after NECTAR-HF, a negative trial that had a follow-up period of 6 months.

Other buzzworthy late-breakers include a study on patient involvement in discharge decisions for low-risk chest pain and an investigation of the relationship between TAVR procedure volume and patient outcomes. The featured clinical research sessions include 3-year results from CoreValve and a study of valve hemodynamic deterioration after TAVR.

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ACC for the Cath Lab: PARTNER II, Delayed DES, Early Beta-Blockers