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10 Oct, 7 tweets, 4 min read
Dr Barili updating meta-analysis from last year - TAVI and SAVR

#EACTS2020
Major updates in data from randomized trials. 5 yr follow-up now doubled!
#EACTS2020
7 trials included with 1 yr data
#EACTS2020
HR 1.00 at 5 yrs. But: proportional hazards assumption not met, so landmark analysis necessary
#EACTS2020
Landmark analysis: 0-24 months HR 0.77 favoring TAVI, 24-48 months HR 1.18 favoring SAVR
#EACTS2020
HR varies over time - reversal after 2 yrs
#EACTS2020
Conclusions: TAVI has survival for 2 yrs, reversal after 2 yr
#EACTS2020

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More from @pomyers

Patrick Myers Profile picture
10 Oct
@kaulcsmc discussing TAVI in low-risk patients
Disclosure: from an impartial observer
#EACTS2020
Current recommendations for TAVR
#EACTS2020
Trial design in TAVI
Total number of total primary outcome events 4x lower in low-risk trial for Sapien. CoreValve more robust by design, yet events 2.5x lower and 2yr follow-up computed.
#EACTS2020
Read 11 tweets
Patrick Myers Profile picture
10 Oct
@BavariaMd giving insights of TVT registry on TAVI
#EACTS2020
Importance of registries
#EACTS2020
Numbers in TVT: ViV represents 6-7%; TAVR
#EACTS2020
Read 13 tweets
Patrick Myers Profile picture
10 Oct
@gbiondizoccai at #EACTS2020
SYNTAX score is an angiographic score of angiographic complexity
Designed to predict feasibility of PCI - nothing to do with feasibility of CABG or outcomes
#EACTS2020
It may prove actually wrong for CABG: a CTO can easily be grafted, yet prediction by SYNTAX would suspect bad outcome.
#EACTS2020
Read 10 tweets
Patrick Myers Profile picture
17 Jul
After almost 1 year, the wait is over - the #EXCEL investigators finally release the UDMI data in @NEJM
nejm.org/doi/full/10.10…
🧵 in a nutshell:
- the EXCEL investigators had the UDMI data, although they said they didn’t
- It shows higher MI risk for PCI
- This is research fraud and the papers should be retracted

@BBCnewsnight have had this data since december, why did it take 7 months more? Gosh @NEJM, what is up?
/2
Main finding: PCI has 2x the incidence of PMI (95%CI: 0.5-3.3), and 4.9x the incidence of all MI when using UDMI (95%CI: 2.6-7.2)

/3
Read 25 tweets
Patrick Myers Profile picture
3 Feb
PVL is decreasing with improving sizing and devices in TAVR. I definitively have this impression from my practice. Or is it really? 1/11
2/ @VictorDayan1 showed in October that the criteria for PVL weren’t the same between PARTNER2 and PARTNER3

3/ VARC-II criteria define mild PVL as circumferential extent <10% and regurgitant volume of <30%.

academic.oup.com/ejcts/article/… Image
Read 12 tweets
Patrick Myers Profile picture
2 Oct 19
After a few days to go over the #EXCEL 5 year results published in @NEJM and thinking hard about @DrMoritzWvB tweet on IC and cardiac surgery seeing things quite differently, here are a few thoughts. Glad to hear your thoughts
@tssmn @ctsnetorg @EACTS
1/30
2/ Congratulations to the investigators for an outstanding RCT! Important question and results, which will have an impact on guidelines. The protocol was powered for non-inferiority of the composite outcome at 3 years, and congratulations for following these patients to 5 years
3/ why were p-values for secondary outcomes reported selectively? e.g. for revascularization, but not others?
Read 34 tweets

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