Eagle's Eye View: Your Weekly CV Update From ACC.org Top Four Trials from TCT 2024: EARLY TAVR, TRISCEND II for Tricuspid Regurgitation, ECLIPSE on orbital atherectomy, and CLEAR SYNERGY (OASIS 9) & colchicine treatment
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Nov 5, 2024 This week, the discussion centers around groundbreaking clinical trials from the recent TCT conference. The EARLY TAVR trial compares TAVR options versus clinical surveillance for aortic stenosis. Insights into the TRISCEND II trial reveal innovations for treating severe tricuspid regurgitation. The ECLIPSE study examines the benefits of orbital atherectomy before PCI. Finally, the CLEAR SYNERGY trial investigates colchicine effects post-PCI for STEMI patients. These trials are set to reshape cardiovascular treatment approaches.
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Early TAVR Benefits
- Early TAVR significantly reduced the composite endpoint of death, stroke, or unplanned hospitalization in asymptomatic severe aortic stenosis patients.
- Surprisingly, nearly 90% of the surveillance group underwent TAVR during follow-up.
TRISCEND II Nuances
- While the Evoque valve improved TR severity, it didn't significantly reduce mortality or heart failure hospitalizations in TRISCEND II.
- The valve's greatest benefit was seen in patients with massive TR, better RV function, and higher functional capacity.
ECLIPSE Findings
- Orbital atherectomy before DES implantation in calcified lesions did not improve outcomes in the ECLIPSE trial.
- It even increased all-cause and cardiovascular mortality at 30 days, possibly due to device-related issues.