Cardiac Arrest and Cardiogenic Shock

There is a societal paper on this in the works too!

Very important work!

@Babar_Basir @venumenon10

#TCT2021 @TCTMD
Methylprednisone - ? not helpful

Advanced reperfusion strategies - small trial

#TCT2021
SCAI Shock Classification

Milrinone vs Dobutamine - no difference

Gaps in pressers in CICU setting: pressers and antiplatelets

@seanvandiepen @JasonKatzMD

#TCT2021
Invasive hemodynamics monitoring

MCS

Unloading

#TCT2021
Shock Teams - CICU @JACCJournals

3-axis model

HF readmission in shock pt

Excellent @Babar_Basir

#TCT2021

@SandeepNathanMD excellent session
***Multi-vessel PCI in Shock***

First side of the coin

Multivessel PCI should not be performed in shock ??

Culprit Shock: Culprit only

NNT = 12

@thiele_holger

#TCT2021
European guidelines

Long term outcomes

STEM pts?
Culprit lesion only PCI and followed by stage PCI in shock
Multivessel PCI in Shock is Way to Go

ESC Guidelines

CI cross in culprit cross at one year?

Metaanalysis - may be there is benefit?

But there is increased risk in renal failure

Culprit is open label - procedural differences?

@BillONeillMD

#TCT2021
NCSI -

77% improved outcomes with support

Culprit vs NCSI

#TCT2021
Conclusion - too nuanced to tell?

#TCT2021
Decisions to use what device in cardiogenic shock

@SandeepNathanMD
Trials and registry data

Impella vs balloon pump
Impella CP in AMI Shock?

#TCT2021
The Pro Case?

Impella CP as first line in shock

Goal in AMI Shock - improved supply/demand

Hemodynamic Effect of IABP, pLVAD, and ECMO

#TCT2021
IABP in AMI-CS

The longer patients linger? the more likely they die...@behnam_tehrani

#TCT2021
Impella Data

Reducing cardiac work

NCSI data @Babar_Basir
Shock teams in patients from the critical care cardiology network @ShashankSinhaMD
Escalation of Device Therapies

- ECMO + Impella (facilitating LV recovery?)

All good, but we need clinical trials in this space.

So far it is hard to argue with @SandeepNathanMD
Excellent session and great speakers @BinitaShahMD @NavinKapur4

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More from @DrDamluji

5 Nov
SURTAVI

No differences in death ,stroke, MI, or HF between TAVR and Surgery during longer follow-up

#TCT2021
Hemodynamics

Total AR and PVL

KCCQ no difference after 1 year

NYHA class at one year 1
Summary for SURTAVI

Self expanding valve

#TCT2021
Read 26 tweets
5 Nov
The use of LV venting to prevent LV thrombus!

#TCT2021
Cardiogenic shock data: excellent presentation by @thiele_holger @HenrytTimothy

#TCT2021
Outcomes in registries = @InovaHealth is up there :)

NCSI data.

@Babar_Basir @BillONeillMD
Read 6 tweets
4 Nov
iFR vs FFR guided coronary Revascularization

iFR-Swedeheart 5 year outcomes

iFR vs FFR (randomized registry)

Study population: stable, unstable angina and NSTEMI

No loss to follow-up

#TCT2021
Results
No difference between iFR and FFR
Read 4 tweets
4 Nov
Radiance-HTN TRIO (investigative device)

Renal denervation

Elevated BP on 3 anti-hypertensives

Randomized (blinded)

Renal denervation vs sham

Follow-up for 6 months

Outcome BP and medication burden

#TCT2021
Tough design
Med adherence
Read 6 tweets
4 Nov
EROSION III

OCT vs angiography

Study population: STEMI

Randomized 1:1

Outcomes MACCE at 1 month and 1 year

#TCT2021
Results
Secondary endpoint and procedural data
Read 5 tweets
4 Nov
SUGAR trial @TCTMD

Cre8 EVO stent (70-80 microm) vs Zotarolimus DES stent

Study population: Patients with diabetics

Outcome target lesion failure (TLF) at 1 year

Design - non-inferiority trial
Procedural characteristics

between Cre8 EVO vs Resolute
anti platelets
Read 5 tweets

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