The America College of Cardiology has released its list of key late-breaking clinical trials at the ACC 2015 meeting in March. Here are my top picks for cardiovascular device technology I am looking forward to hearing data on:
1. Perhaps the key trial at ACC will be data from the large BEST study, which compares the Xience V drug-eluting stent (DES) to coronary bypass grft (CABG) surgery in patients with multivessel disease. It is a follow up to the SYNTAX trial, which fell short in showing the Taxus DES (at the time the top-performing stent) had long-term durability compared to CABG. However, Abbott's Xience second-generation DES beat out Taxus in the SPRIRT IV trial a couple years ago. Intervascular imaging and FFR today also see more expanded use, which combined with an improved stent platform, is expected to tip the scale in favor of stenting.
2. More data will be presented, likely further supporting the use of transcatheter aortic valve replacement (TAVR). This includes long-term outcomes from the Edwards Sapien and Medtronic Corevalve trials, and first experience with use of a TAVR embolic protection system. The most important of the trial presentations might be data from an all-comers trial of TAVR verses surgery. This data could help open the flood gates for TAVR as a standard therapy to replace open heart procedures.
3. Use of CT angiography to evaluate patients presenting with chest pain to reduce costs. There a a few CTA trials being presented, which I suspect will add more evidence that CTA can be used as a primary rule-out test to help eliminate series blood testing, nuclear scans, stress tests and diagnostic angiograms.
4. Denervation to treat pulmonary hypertension. Renal denervation trials have had very mixed results, but experts still say the denervation may hold promise for other therapeutic areas such as this one.
5. Initial experience and outcomes with the MitraClip mital valve leaflet repair system. I believe this is just the beginning of a whole new segment of interventional mitral valve repair therapies that will eventually replace open heart mitral procedures.
6. There are two trials comparing transradial access, which is a growing trend in the United States to help lower access site complications. One will compare transradial to transfemoral access sites, and another radial verses ulnar access.
November 30, 2023 
