Every year, much of the interventional cardiovascular community looks to EuroPCR to witness the latest advances in the way we approach healthcare, and 2018 was no different. From product launches and clinical trial results to intriguing polls and debates on hot topics and techniques, EuroPCR 2018 had it all—and our cardiovascular insights analysts at DRG Medtech have been brimming with anticipation to highlight some of this year’s most noteworthy insights.
With no further delays, here are our four most significant takeaways from EuroPCR 2018:
- Hope for Renal Denervation: Humble BP Reductions
Renal denervation is back with a bang. Two sham-controlled trials, SPYRAL HTN-ON MED and RADIANCE-HTN SOLO, revealed the efficacy of radiofrequency-based renal denervation by reducing systolic blood pressure among patients with hypertension in the absence or presence of antihypertensive medications.
“We’re not getting pre-HTN3 levels of hype here, but this is definitely a good sign for renal denervation. Combined with the OFF-MED results presented last year, this shows that there is really an effect of renal denervation, though not as large as what was once thought.”
—Sean Messenger, Senior Manager, Cardiovascular Insights
- iFR—The Newbie in Coronary Imaging
Results from the randomized 5-year FAME II trial and 10-year SCAAR registry data showed a reduced risk of myocardial infarction among patients with stable coronary disease when fractional flow reserve (FFR)-guided percutaneous coronary interventions (PCIs) are performed, while results from the DEFINE-FLAIR trial showed that instantaneous wave-free ratio (iFR)-guided PCI is a more cost-effective option—saving nearly $900 USD according to trial estimates—than using FFR.
“Recent positive results coming out of FAME II, SCAAR, and DEFINE-FLAIR proving cost-effectiveness and better clinical outcomes, aided with better patient comfort, will further expand the patient population for FFR. I strongly believe that as a leader in the FFR segment, Philips Healthcare will have an immediate upper hand in the intravascular imaging market, but the favorable data will also encourage other manufacturers to focus and develop this technology further by assessing tremendous potential of the device.”
—Swarnadip Dutta, Senior Analyst, Cardiovascular Insights
- Magmaris Spreads the Positivity Again
BIOTRONIK’s Magmaris is a unique, polymer-free BVS system that is absorbed into the body within 1 year after implantation as opposed to the 3 years associated with Abbott Vascular's Bioresorbable Vascular Scaffold (BVS). Unlike Abbott Vascular, BIOTRONIK is ensuring that proper implantation techniques are practiced by clinical investigators and physicians, which significantly reduces the risk of target lesion failure (TLF). New 1-year results from the BIOSOLVE-IV registry demonstrated comparable outcomes between the Magmaris BVS and second-generation drug-eluting stents (DES), with only one instance of scaffold thrombosis.
“Despite the difficulties experienced by the Absorb BVS, bioresorbable devices still represent the future for coronary stents. Positive clinical data for BIOTRONIK's Magmaris BVS will encourage adoption of the product in the absence of the Abbott Vascular’s BVS, supporting further gains for the several other promising BVS devices currently under development. I am a believer that BVS technology will eventually be positive.”
—Megha Maheshwari, Principal Analyst, Cardiovascular Insights
- ORBITA Sends Cardiologists on a Roll
ORBITA is the first placebo-controlled trial to use FFR and iFR to predict the efficacy of PCI. Results from this trial, indicated that PCI shows no benefit in exercise tolerance compared to a sham procedure. Interventional cardiologists are hesitant to embrace the findings of ORBITA given that this could potentially switch the treatment paradigm back from invasive treatment to pharmacotherapy.
“The ORBITA trial demonstrated no difference between PCI- and placebo-treated patients with stable angina, further supporting the notion that many stable coronary artery disease patients can be medically managed without the need for invasive procedures. This will have an impact in the forthcoming guidelines of stable coronary disease.”
—Nithu Mariya Johnson, Research Associate, Cardiovascular Insights