Highlights from TCT 2024 with Dr Deepak L. Bhatt

Transcript:

0:10: What have been the standout moments for you here so far?

There have been a lot of great trials presented at this TCT. A lot of energy at this meeting as well. I'd say maybe the most exciting things have to do with TAVR and early TAVR and the data supporting earlier intervention with TAVR in severe but asymptomatic aortic stenosis. More broadly though, I think that brings light to the fact that there are lots of patients out there that could potentially benefit from interventional techniques that might not actually be getting them. So, it does also fit into that broader message. And I think in the future we're going to be much more aggressive about screening for severe aortic stenosis even when it's asymptomatic, and potentially that'll be a paradigm that we utilize in other aspects of cardiology as well. Obviously, we would need randomized clinical trials to support it, but I'm referring to, perhaps in the future, broader screening strategies for severe coronary artery disease. There's trials going on now to look at that, to see whether things like CT angiography can be useful to identify, in a primary prevention setting, high -risk patients. And some proportion of those patients maybe would benefit from revascularization. So again, this idea of getting asymptomatic patients who have really bad disease and treating them before problems arise might be one that catches on broadly in the world of cardiology and interventional cardiology. Have to see what future trials show.

1:43: Have you found any emerging trends or innovations in the field that are particularly exciting?

One thing that I found interesting, and maybe I'll say even refreshing, was that a number of trials in the coronary space and the structural space are incorporating quality of life in their endpoints. So instead of just looking at mortality, which is important, but not always easy to influence, looking at things like the Kansas City Cardiomyopathy Questionnaire, which was very common in heart failure trials, rather unusual in interventional trials. So, this focus on how the patient is feeling, their quality of life, I think is a really good shift in interventional cardiology trials.

2:23: Can you give us a quick overview of the sessions you are leading or on the panel for here?

I was on a few different panels and sessions. One theme that was really hot, if I may use that term here, was inflammation. Actually, just a little bit earlier today, I was in a symposium where we were discussing strategies to target inflammation as an additional way of addressing residual cardiovascular risk. A late-breaking clinical trial that was presented here was the CLEAR SYNERGY Trial by Dr Sanjit Jolly. I chaired the Data Safety Board for that trial. That was a trial of STEMI and NSTEMI patients getting PCI randomized within 72 hours to colchicine or placebo. And a lot of people thought that that trial would be positive based on some older, smaller studies. But in fact, the hazard ratio was essentially one, really no benefit of that approach in a population that was otherwise being treated very well. So it underscores the importance of doing randomized clinical trials, especially large, well -powered ones, as CLEAR SYNERGY was, and also points to the still ongoing interest, excitement, in acute coronary syndromes. There's still a lot we can do, of course, with respect to intervention, but also with respect to adjunctive medical therapy. And hopefully in the future, the Journal of Invasive Cardiology will get more submissions, not just about the technical aspects of intervention, but even the concomitant medical therapy.

3:51: Speaking of JIC, as editor-in-chief, and given what stood out to you at this conference, are there any research topics you would especially like to encourage authors to submit to the journal?

I think a really unique aspect of the Journal of Invasive Cardiology is that it covers lots of different topics. It covers invasive cardiology, so, it's not just one branch of intervention, we take everything. So, of course we're interested in coronary intervention, acute coronary syndromes, structural heart, whether it's left- or right-sided or evolving procedures, we're interested in cerebral vascular intervention, in peripheral artery intervention, in venous intervention. So, it's really the full gamut of cardiac intervention — whether it's coronary, peripheral, cerebral vascular, or structural, we're interested in it all. In fact, we also take submissions that pertain to electrophysiology as it comes up in daily invasive cardiology practice. So, it's a very, very wide gamut of topics that we're interested in in invasive cardiology. Historically, it's been focused more on the technical and procedural aspects, that's been a longstanding strength, but really we're happy to cover anything that's related to interventional cardiology, even if it's the medical side and not just the procedural side. So, any of those topics we're really interested in. And we've been historically strong in describing new techniques, whether they're things that people have developed in their cath lab, whether it's been studied at multiple sites, multi-center studies and trials, really that entire spectrum we're interested in. There are a lot of firsts that have been described in the Journal of Invasive Cardiology, and hopefully that will continue.

5:28: Does the journal have any developments in the works that you'd like to share?

Well, you know, we would really like to refresh, recharge, re-energize a lot of aspects of the journal. You might note that we've got a huge social media presence. In addition to that, it'd be nice to refresh some of our different editorial board members, our section editors, our reviewers. You know, after a period of time, people sometimes get tired of doing the same thing, a refresh is needed, and that's what we're planning to do, put out a call for new section editors, for new editorial board members, and for new reviewers. So, if you're If you're interested, please go ahead and contact our managing editor, Laura Simson (lsimson@hmpglobal.com).

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