Prof. Dr. Mustafa Gökhan Vural

Left Ventricular Unloading in High-Risk Percutaneous Coronary Intervention Among patients with severely impaired left ventricular function undergoing complex PCI, elective left ventricular unloading with a microaxial flow pump did not reduce the risk of major adverse clinical outcomes at a minimum of 12 months. #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @NEJM @CMichaelGibson @DrMarthaGulati @hvanspall @Hragy @cardioceptor @ankeetbhatt nejm.org/doi/full/10.10…

🫀 SPIRIT-HF at #ACC26: Spironolactone, an aldosterone blocker, compared with placebo, did not show any significant improvement in terms of HF hospitalizations and cardiovascular death at 24 months in patients with #HFpEF or #HFmrEF. See the results ➡️ bit.ly/4cbiPeW

#LAAC where is the truth? whereas #CLOSURE-AF was not totally negative, #CHAMPION-AF is not all positive. methodologically both trials have instrumental limitations leaving the clinical indication of a #LAAC not clear. to me: 1/ important to select the pt who can benefit the most. probably too high risk pts are not a correct target. 2/for the rest, to have a correct informed consent and discussion with the pts is more important now than ever: we need to inform them that with #LAAC we may prevent non-major bleeding, but for the rest is the same. and periprocedural complications should be considered in this equation. 3/role of #AF ablation is likely underestimated. #LAAC advantages may probably come from #AF ablation rather than from the procedure itself? see #OPTION in @NEJM and #CHAMPION-AF where almost half of the pts had such procedure. 4/waiting for a metanalysis in this topic, which will be unfortunately limited by differences in endpoints between the various trials. a MA based on individual patient data would be needed! 5/last but not least we have to admit that in theory #LAAC should have won easily against #NOAC in terms of stroke and reduced bleeding but it did not. We need to be very cautious, thinking that we are not at a stage to make #LAAC to all our patients, but to some of them. and this is important because we should maintain our critical thinking against any kind of industries claims about #LAAC and I would be curious to see if it is cost-effective... #tricuspid interventions docet @PCRonline @ACCinTouch @escardio @TCTMD @shci_sec @sicigise @secardiologia

Questioning the benefit of an implant to close the left atrial appendage vs medical therapy in a randomized trial @NEJM nejm.org/doi/full/10.10…