New trials and registries

In this session, Chaired by Moidrag Ostojic and Mohammed Balghith, attendees heard data from Morris Mosseri and Bruno Farah on the use of a chitosan pad originally tested during conflicts in Iran and Afghanistan. Chitosan reduced the time needed to stop bleeding in low-risk patients after percutaneous femoral angiography in this randomised, openlabel study. Larger mutlicentre studies and cost-effectiveness analyses are needed to further confirm this.

Jochen Wohrle and Volker Schächinger reviewed data from a small, randomised study on stem cell therapy in patients with acute myocardial infarction (SCAMI). This study was stopped after an interim analysis as it failed to show an improvement in left ventricular ejection fraction, volumes or infarct size. More robust methodologies, which consider stopping rules, patient type, stem cell preparations and endpoints, may show a difference between groups.

Bernardo Cortese and Adam de Belder presented results from the non-inferiority PICCOLETO trial that compared paclitaxel-eluting balloons with paclitaxel-eluting stents in small coronary vessel disease. Equivalence in angiographic restenosis was not shown and further study is needed for clarification.

Francesco Prati and Leif Thuesen discussed data from the blinded, REVEAL study that used optical coherence tomography at 7 and 30 days to investigate vessel healing after angioplasty. Data show better coverage for Catania® and cobalt chromium stents vs. drugeluting stents, which may lead to less in-stent thrombosis. Prospective studies are needed.

Hyeon Cheol Gwon reviewed the use of dual antiplatelet therapy after zotarolimus-eluting stent implantation in low-risk patients. This 823 patient, real-life, DATE registry showed that the favourable safety profile of zotarolimus allowed clopidogrel discontinuation after 3 months without increasing the risk of clinical events. Large randomised, controlled trials are needed to confirm this.

Elmir Omerovic and Marko Noc summarised data from a large 12-year, Swedish prospective registry (SCAAR) that included 65,044 patients. These real life data indicate almost 60% of patients with in-stent restenosis present with subsequent AMI or unstable angina. This suggests that restenosis is not a benign condition and may be an important target for improving clinical outcomes.