Clinical Cardiology Alert – January 1, 2015

January 1, 2015

• DAPT Trial Adds Both Clarity and Confusion to the Debate Over Optimal Duration of Dual Antiplatelet Therapy

  Dual antiplatelet therapy (DAPT) following coronary stenting is essential for the prevention of stent thrombosis, which can occur due to a response to the vascular scaffold, as well as to the local inflammation that occurs after angioplasty. DAPT after drug-eluting stent (DES) implantation is currently recommended for at least 12 months in the United States and for 6 months in Europe.

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• Paradoxical Low-flow, Low-gradient AS

  Low-flow, low-gradient aortic stenosis (AS) is usually associated with reduced left ventricular (LV) performance. When LV systolic function is normal, it has been labelled paradoxical.

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• Carotid Artery Stenting Bested by Endarterectomy in Asymptomatic Patients

  Although carotid artery stenting (CAS) is a less invasive means of carotid revascularization, multiple trials have demonstrated an increased risk of post-procedural stroke in patients with symptomatic carotid stenosis, as compared to carotid endarterectomy (CEA).

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• Alcohol Septal Ablation vs Surgical Myectomy for HOCM

  Symptomatic left ventricular outflow tract (LVOT) obstruction is common in patients with hypertrophic obstructive cardiomyopathy (HOCM), and medical therapy does not always relieve the symptoms. In such cases, septal reduction therapies are indicated, and both alcohol septal ablation (ASA) and surgical myectomy have been proven to reduce symptoms effectively.

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• Can Intracardiac Echo Be Used As a Substitute for Transesophageal Echo Prior to Atrial Fibrillation Ablation?

  Transesophageal echocardiography (TEE) is commonly performed prior to atrial fibrillation (AF) ablation to exclude left atrial appendage thrombus.

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