Jose Ramon Rumoroso

This year, TCT is stopping in San Diego (and I’ll have to take three flights to get there), and the late-breaking lineup is quite interesting. Here are my favourites, both journalistically and from an interventional cardiology perspective: 1/ P4, a trial of CCTA-guided vs IVUS-guided PCI. We published the design paper in EuroIntervention. Check it out: eurointervention.pcronline.c… 2/ TRANSFORM II, or DCB strategy vs DES, Act III. With REC-CAGEFREE I coming out negative and SELUTION DeNovo being so-so, we really needed a tiebreaker. And here it is. 3/ HD-PCI, a randomized trial of higher vs lower-dose heparin for PCI. I like trials that answer practical, “in or out” questions. I also have to discuss this one right after the presentation, so I’m studying it carefully. 4/ PROGRESS: TAVR or clinical surveillance for moderate aortic stenosis. I still haven’t quite figured out the ambition and magnitude of these TAVR trials in moderate AS. The first one, TAVR UNLOAD, didn’t leave much of a mark. We don’t know when EXPAND TAVR II will be presented, but I suspect it’ll be soon. And then there’s PROGRESS, the largest of them all in terms of patient numbers. By the way, ClinicalTrials.gov says follow-up will end in 2037. As we say back home, campa cavallo. 5/ SIMPLAAFY, antithrombotic monotherapy after left atrial appendage occlusion. I like this trial if only for its name, and I can’t wait to hear how people pronounce it. More importantly, it could give DAPT a serious shove out the door, since it seems to be the main burden holding back LAAO at the moment. 6/ PIONEER IV, angiography-derived FFR vs usual care for lesion selection and optimization in all-comers PCI. Another QFR trial occupying an intermediate position on the physiology spectrum between FAVOR III Europe and FAVOR III China. 7/ VERONICA, where researchers are trying to demonstrate the usefulness of platelet-function testing to identify patients with excessive platelet inhibition (usually, it’s the opposite) and see whether a de-escalation strategy could reduce the combined risk of ischemic and bleeding events.