http://www.theheart.org/editorial-program/1231879.do EuroPCR 2011 took place in Paris and key trials/topics presented at the conference include: RECLOSE 2-ACS, DISCOVER FLOW, TAVI, Renal denervation, BASE-ACS, SOURCE, DES meta-analysis, SCAAR registry

1. EuroPCR 2011 research highlights:
A slideshow presentation

2. EuroPCR 2011 Research Highlights
EuroPCR 2011 took place in Paris, France, from May 17 through May 20,
2011. The conference was attended by 12 567 people.
Key trials/topics presented at the conference include:
RECLOSE 2-ACS: Poor clopidogrel responders with ACS face twofold
risk of cardiac death
DISCOVER FLOW: Adding function to CTA with "noninvasive FFR" ups
accuracy, may cut procedures
TAVI spotlight swings to risks of paravalvular leaks
Renal denervation: Wider role for procedure considered, amid calls for
more studies
BASE-ACS: Could a bare-metal stent be "noninferior" to a leading DES?
SOURCE: New numbers from registry bolster PARTNER results in real
world
DES meta-analysis: Less stent thrombosis with biodegradable vs
permanent polymers
SCAAR registry: Transradial PCI cuts mortality in STEMI
View our complete EuroPCR coverage here.

3. RECLOSE 2 ACS
Responsiveness to Clopidogrel and Stent-Related Events
in Acute Coronary Syndromes
Results: ACS patients identified as being "poor
responders" to a 600-mg loading dose of clopidogrel face
a twofold risk of cardiac death in the next few years,
results from the RECLOSE 2 ACS study show. Of note,
however, doubling the maintenance dose of clopidogrel
or shifting patients to ticlopidine did not appear to
mitigate this risk over time.
"This will allow us to narrow the focus of where we're going
to be using the more potent agents, because clopidogrel
still has a role," said Dr Dominick Angiolillo (University of
Florida College of Medicine, Jacksonville)."Even in ACS
patients, there are patients who respond to clopidogrel and
do well."
See: Poor clopidogrel responders with ACS face twofold
risk of cardiac death: RECLOSE 2 ACS

4. DISCOVER FLOW
Results: As arguments over the necessity of stent procedures
and imaging tests approach a fever pitch, a new computer
modeling system that can add functional information to standard
coronary computed-tomography (CT) angiography may once
again shake up the world of diagnostic imaging and clinical
decision making. According to study investigators, the new
technique, dubbed noninvasive fractional flow reserve (FFRCT),
can dramatically improve the diagnostic accuracy of CT imaging
without the need for an invasive test, adenosine, or additional
radiation exposure.
"This noninvasive 'all-in-one' technology may reduce unnecessary invasive coronary angiography and revascularization
procedures," said Dr Bon-Kwon Koo (Seoul National University Hospital, Korea). "Because this model starts with just
conventional CT imaging, there are no [additional] radiation, imaging procedures, or medication. Any CT images, taken
from any lab, can be transferred to this novel technology."
See: Adding function to CTA with "noninvasive FFR" ups accuracy, may cut procedures: DISCOVER FLOW

5. TAVI Spotlight
Summary: Paravalvular leaks are extremely rare in surgical aortic-valve
replacement--seen in just 1.5% to 2% of cases. But as experts observed at
EuroPCR 2011, mild paravalvular leaks are relatively common in
transcatheter aortic-valve implantation (TAVI). New data presented at the
conference suggest that more severe paravalvular aortic regurgitation (AR)
is a key reason for prosthetic valve dysfunction.
"Our primary focus initially was actually on device success and procedural success, so people were focusing on implanting
the devices in the correct position and without perivascular complications--the focus was not so much on aortic
regurgitation or residual regurgitation," said Dr Peter Wenaweser (Bern University Hospital, Switzerland). "Now we are
quite happy about all the device success and the hemodynamic performance as well, so now . . . we are now trying to get a
better understanding of how we can further improve this technology."
See: TAVI spotlight swings to risks of paravalvular leaks

6. Renal denervation
Summary: Interventional cardiologists gathered at EuroPCR
2011 mulled the potential new applications for renal
denervation--the centerpiece of the "live case" presentation that
kicked off this year's meeting--even as they admitted that the
very limited data supporting the procedure in resistant
hypertension need to be replicated in larger studies. The
speculation on future uses comes as longer-term data from the
Symplicity HTN-1 pilot study are published in the May 2011
issue of Hypertension.
"We have relatively limited numbers of patients who have been included in the trials, yet the potential size of the population who
could benefit is huge," session chair Dr William Wijns (Cardiovascular Center Aalst, Belgium) observed. "Should this mismatch
be addressed by larger trials?"
See: Wider role for renal denervation considered, amid calls for more studies

7. BASE-ACS
Comparison of Bio-Active-Stent to the Everolimus-Eluting Stent
in Acute Coronary Syndrome
Results: BASE-ACS, presented during the late-breaking clinical-
trials session at EuroPCR 2011, showed the Titan-2 BAS
(Hexacath) bare-metal stent to have nearly identical rates of
major adverse cardiovascular events (MACE) as the market-
leading Xience V (Abbott Vascular) at 12 months, in ACS
patients.
"The present study suggests that a stent coated with titanium
nitride-oxide represents a safe and effective alternative to
Xience V everolimus-eluting stents in ACS patients," concluded
Dr Pasi Karjalainen (Heart Center, Satakunta Hospital, Pori,
Finland).
See: BASE-ACS: Could a bare-metal stent be "noninferior" to a
leading DES?

8. SOURCE Registry
Results: New numbers from the SOURCE registry,
which tracks patients treated with the Sapien valve
(Edwards) by either the transapical or transfemoral
route, suggest that the groundbreaking randomized
controlled PARTNER trial results are more or less in
keeping with outcomes seen in "real-world" practice
outside the US. One-year survival for the entire
cohort (over 23,000 patients) was 76.5%, climbing to
80.1% in the transfemoral group and dipping to
74.2% in the transapical group.
The registry gives "very good information . . . in real-world terms, in all [the types of] patients coming for this kind of treatment,"
said Dr Olaf Wendler (Kings College Hospital, London, UK) . "On the other hand, it's not covering all implantations of the
Sapien valves, and it's not covering all the implantations with other devices. In the end, there are no better data than these, but
they cover only one part of the TAVI experience at the moment."
See: New SOURCE numbers bolster PARTNER results in real world

9. DES meta-analysis:
Biodegradable vs permanent polymers
Results: A new meta-analysis with three-year data is offering
the first solid proof that drug-eluting stents (DES) with
bioerodable polymers are associated with less stent thrombosis
and better clinical outcomes than stents with permanent
polymers.
"The issue to date has been that because late adverse events
are very rare, we need large numbers of patients so we can
detect any differences," said Dr Robert Byrne (Deutsches
Herzzentrum, Munich, Germany. "I think this is probably the first
time that we've detected a clear signal toward reduced clinical
events. It may be that these differences only start to emerge or
we can only tease them out after three years, and earlier time
points aren't really showing the benefit of these platforms."
See: Less stent thrombosis with biodegradable vs permanent
polymers: Meta-analysis

10. SCAAR Registry
Results: Use of radial PCI in the treatment of STEMI
patients in Sweden is associated with a 22% reduction in
mortality and lower rates of bleeding and
rehospitalizations, a new retrospective analysis of the
SCAAR registry suggests.
"While the study supports the feasibility and safety of
radial for STEMI, it does not contribute to [the question
of] the comparison with transfemoral, due to case
selection, time-sensitive anticoagulation regimens, and
crossover," said Dr Ron Waksman (Washington
Hospital, Washington, DC). "Operators should continue
to perform PCI with the access that they feel comfortable
with, and there is not sufficient evidence from this study
to switch to radial from femoral."
See: SCAAR registry: Transradial PCI cuts mortality in
STEMI

11. For more information
EuroPCR
EuroPCR 2011 coverage on theheart.org
EuroPCR 2011 coverage on Medscape

12. Credits and disclosures
Editor-in-Chief/Journalist:
Shelley Wood
Managing Editor, heartwire
Kelowna, BC
Disclosure: Shelley Wood has disclosed no relevant financial relationships.
Contributor:
Steven Rourke
Manager, Editorial Programming
theheart.org
Montreal, QC
Disclosure: Steven Rourke has disclosed no relevant financial relationships.

13. More slideshows
HRS 2011 research highlights
ACC 2011 research highlights
AHA 2010 research highlights: A slideshow
presentation
TCT 2010 research highlights: A slideshow
presentation

14. Become a member of http://www.theheart.org
Become a fan on Facebook: http://www.facebook.com/theheartorg
Follow us on Twitter: http://www.twitter.com/theheartorg
theheart.org is the leading online source of independent cardiology news.
We are the top provider of news and opinions for over 100 000 physicians.