Turkish Society of Cardiology Young Cardiologists Bulletin / "TSCYOUNG" Ağustos 2021 (1)

[Türkçe]

Turkish Society of Cardiology Young Cardiologists Bulletin Year: 4 Number: 1 / 2021

Turkish Society of Cardiology
Young Cardiologists
President
Dr. Muzaffer Değertekin

Coordinator for the
Board of Directors
Dr. Ertuğrul Okuyan

Coordinator for the
Board of Directors
Dr. Can Yücel Karabay

Members
Dr. Adem Aktan
Dr. Gülşah Aktüre
Dr. Bayram Arslan
Dr. İnanç Artaç
Dr. Ahmet Oğuz Aslan
Dr. Görkem Ayhan
Dr. Ahmet Anıl Başkurt
Dr. Özkan Bekler
Dr. Oğuzhan Birdal
Dr. Yusuf Bozkurt Şahin
Dr. Serkan Bulgurluoğlu
Dr. Ümit Bulut
Dr. Veysi Can
Dr. Mustafa Candemir
Dr. Murat Çap
Dr. Göksel Çinier
Dr. Ali Çoner
Dr. Yusuf Demir
Dr. Ömer Furkan Demir
Dr. Murat Demirci
Dr. Ayşe İrem Demirtola Mammadli
Dr. Süleyman Çağan Efe
Dr. Mehmet Akif Erdöl
Dr. Kubilay Erselcan
Dr. Kerim Esenboğa
Dr. Duygu Genç
Dr. Kemal Göçer
Dr. Elif Güçlü
Dr. Arda Güler
Dr. Duygu İnan
Dr. Hasan Burak İşleyen
Dr. Muzaffer Kahyaoğlu
Dr. Sedat Kalkan
Dr. Yücel Kanal
Dr. Özkan Karaca
Dr. Ahmet Karaduman
Dr. Mustafa Karanfil
Dr. Ayhan Kol
Dr. Fatma Köksal
Dr. Mevlüt Serdar Kuyumcu
Dr. Yunus Emre Özbebek
Dr. Ahmet Özderya
Dr. Yasin Özen
Dr. Ayşenur Özkaya İbiş
Dr. Çağlar Özmen
Dr. Selvi Öztaş
Dr. Hasan Sarı
Dr. Serkan Sivri
Dr. Ali Uğur Soysal
Dr. Hüseyin Tezcan
Dr. Nazlı Turan
Dr. Berat Uğuz
Dr. Örsan Deniz Urgun
Dr. İdris Yakut
Dr. Mustafa Yenerçağ
Dr. Mehmet Fatih Yılmaz
Dr. Yakup Yiğit
Dr. Mehmet Murat Yiğitbaşı

Bulletin Editors
Muzaffer Değertekin
Bülent Mutlu
Süleyman Çağan Efe
Alper Karakuş
Oğuzhan Birdal

Bulletin Preparation
Dursun Akaslan
Betül Balaban Koçaş
Süleyman Çağan Efe
Cem Çöteli
Muhammet Dural
Alper Karakuş
Örsan Deniz Urgun
Oğuzhan Birdal
Göksel Çinier

Turkish Society of Cardiology Young Cardiologists Bulletin / "TSCYOUNG" Ağustos 2021 (1)

Turkish Society of Cardiology Young Bulletin 4:1

Dear Colleagues
As the Young Cardiologists Group of the Turkish Society of Cardiology, we are pleased to present the first issue of the TSC Bulletin for 2021, which includes the latest randomized clinical trials in the field of cardiology.
The studies in the bulletin were selected from the studies published at the ACC 2021 congress. The studies have been summarized as briefly as possible to provide an overview, provide both informative and useful references for daily practice.
Thanks to our colleagues who contributed to bulletin. We hope it will be a useful resource for our colleagues.

Issue Summary


	The TALOS-AMI trial (TicAgrelor Versus CLOpidogrel in Stabilized Patients With Acute Myocardial Infarction) Dr. Dursun AKASLAN
	It has been shown in PLATO and TRITON-TIMI-38 studies that the use of more potent P2Y12 inhibitors such as ticagrelor and prasugrel instead of clopidogrel treatment for 1 year in patients with acute coronary syndrome undergoing percutaneous coronary intervention significantly reduces the frequency of ischemic events.


	Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-Term Effectiveness- ADAPTABLE Dr. Betül Balaban Koçaş
	The dose of aspirin required to reduce the risk of death, myocardial infarction and stroke in people with atherosclerotic cardiovascular disease and to minimize major bleeding is still a controversial issue.


	Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention- TWILIGHT Dr. Betül Balaban Koçaş
	Potent P2Y12 receptor inhibitor monotherapy following shortened dual antiplatelet therapy reduces bleeding after percutaneous coronary interventions without increasing ischemic events.


	Harmonizing Optimal Strategy for Treatment of coronary artery diseases-EXtended Antiplatelet Monotherapy- HOST-EXAM Dr. Betül Balaban Koçaş
	In patients who have completed the required period of dual antiplatelet therapy after percutaneous coronary interventions (PCI), indefinite single antiplatelet therapy is recommended for secondary prevention of atherosclerotic cardiovascular events, but the question of optimal agent is unclear.


	Pirfenidone in Heart Failure With Preserved Ejection Fraction – PIROUTTE Dr. Süleyman Çağan Efe
	Pirfenidone is a drug used in the treatment of idiopathic pulmonary fibrosis with antifibrotic and collagen formation inhibitory effects. It is known that ACE inhibitors and ARBs have beneficial effects on fibrosis, which has an important place in the pathophysiology of heart failure.


	Effect of Sotagliflozin on Cardiovascular Events in Patients With Type 2 Diabetes Post Worsening Heart Failure - SOLOIST-WHF Dr. Süleyman Çağan Efe
	The prior DAPA-HF study , dapagliflozin heart failure patients and in the EMPEROR-Reduced study empagliflozin in HF patients with reduced EF , demonstrated the mortality and morbidity benefits of SGLT2 inhibitors independent of T2DM status. The results of the EMPEROR-preserved trial are expected to be announced at ESC 2021. Sotagliflozin is a sodium-glucose cotransporter-2 (SGLT2) inhibitor, but also acts by inhibiting SGLT1, which is found primarily in the gut and appears to delay glucose absorption.


	Effect of Sotagliflozin on Cardiovascular and Renal Events in Patients With Type 2 Diabetes and Moderate Renal Impairment Who Are at Cardiovascular Risk – SCORED Dr. Süleyman Çağan Efe
	It is known that SGLT2 inhibitors have positive contributions on cardiovascular events independent of diabetes mellitus in patients with heart failure . The effects of SGLT2 inhibitors on patients with chronic kidney disease have been shown in the previous DAPA-CKD study to reduce renal events even in the absence of T2DM.


	Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke (LAAOS III Trial) Dr. Cem Çöteli
	Atrial fibrillation is a common disorder in the elderly population. Cardioembolic events are responsible for a quarter of ischemic stroke and the left atrial appendage is generally the origin of the thrombus formation in these events. Even though oral anticoagulant drugs are effective for thromboembolic prevention, they have some disadvantages. Left atrial appendage occlusion could be performed concomitantly in patients who will undergo cardiac surgery.


	TRISCEND: Transfemoral Tricuspid Valve Replacement In Patients With Tricuspid Regurgitation Dr. Cem Çöteli
	Even the recent guidelines suggest surgery for severe tricuspid valve regurgitation, an important number of the patients with severe tricuspid valve regurgitation are not candidates for surgery because of many comorbidities or previous heart surgery history. Consequently, percutaneous tricuspid valve interventions are under investigation, and the EVOQUE system is one of them.


	Etripamil Nasal Spray Relieves Symptoms and Reduces Emergency Room Interventions in Patients with Paroxysmal Supraventricular Tachycardia (PSVT) Dr. Cem Çöteli
	Etripamil is a novel L-type calcium channel blocker. It is administered as a rapidly acting nasal spray and developed as a self-administered therapy to terminate AV nodal-dependent PSVT.


	Effect of a Hospital and Postdischarge Quality Improvement Intervention on Clinical Outcomes and Quality of Care for Patients With Heart Failure With Reduced Ejection Fraction: The CONNECT-HF Dr. Muhammet Dural
	Currently, recurrent hospitalization and death rates are still high in patients with reduced ejection fraction heart failure (HFrEF). In addition, the rate of use of guideline-directed medical treatment is not at the desired level. There is limited data on the effectiveness of in-hospital and post-discharge quality improvement intervention. In CONNECT-HF study, the quality improvement intervention applied in hospital and after discharge in patients with HFrEF was compared with the usual care approach.


	Anti-Thrombotic Strategy to Lower All cardiovascular and Neurologic Ischemic and Hemorrhagic Events after Trans-Aortic Valve Implantation for Aortic Stenosis – ATLANTIS Dr. Alper Karakuş
	There is no current evidence in the literature that new generation oral anticoagulants (OACs) can replace standard antiplatelet therapy (APT) or Vitamin K antagonists (VKA) after transcatheter aortic valve replacement (TAVR). However the GALILEO study showed more harm than benefit with low-dose rivaroxaban compared to APT.


	FLOWER-MI (Flow Evaluation to Guide Revascularization in Multivessel ST-Elevation Myocardial Infarction) Dr. Dursun AKASLAN
	Many studies have shown that FFR is superior to angiography in patients with chronic coronary syndrome. In patients with ST elevation myocardial infarction, it was shown in the DANAMI3-PRIMULTI study that FFR-guided complete revascularization was more successful in only infarct related lesion revascularization. Comparison of FFR and angiography guided total revascularization of patients with STEMI and multivessel disease has not been made.


	Vascular Outcomes Study of ASA Along with Rivaroxaban in Endovascular or Surgical Limb Revascularization for Peripheral Artery Disease - VOYAGER PAD Dr. Örsan Deniz URGUN
	Peripheral artery disease (PAD) patients undergoing lower extremity revascularization (LER) are at high risk for major adverse extremity and cardiovascular events. The benefit of rivaroxaban on total events in this population is unknown.


	Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM) Dr. Oğuzhan Birdal
	Hypertrophic Cardiomyopathy is a primary myocardial disease characterized by unexplained left ventricular hypertrophy caused by pathogenic variants of sarcomeric genes. The main goal of treatment is symptomatic improvement. However, current treatment options are not specific and sufficient for this disease. Mavacamten is a direct myosin inhibitory agent that reduces contractility.


	Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure- GALACTIC-HF Dr. Göksel Çinier
	Myotropes represent a new class of drugs that improve myocardial function by directly augmenting cardiac sarcomere function. The cardiac myosin activator, omecamtiv mecarbil works by improving the ability for heart muscle cells to contract and operates through a different biological pathway than any of the current heart failure medications.


	LCZ696 in Advanced Heart Failure - LIFE Dr. Muhammet Dural
	It may not always be possible to apply guideline-directed therapy optimally in patients with advanced symptomatic low ejection fraction heart failure (HFrEF). In these patients, symptomatic hypotension and/or deterioration in renal function may develop earlier, which may lead to discontinuation or dose reduction of some drugs.


	Prospective ARNI vs. ACE inhibitor trial to DetermIne Superiority in reducing heart failure Events after Myocardial Infarction (PARADISE-MI) Dr. Göksel Çinier
	Previous studies demonstrated that sacubitril/valsartan reduced adverse outcomes compared to ramipril among patients with chronic heart failure. This led to class I indication for sacubitril/valsartan in this population.


	Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction - PARAGON-HF Dr. Muhammet Dural
	Heart failure with preserved ejection fraction (HFpEF) can lead to significant morbidity and mortality. Treatment options that can improve clinical outcomes in these patients are not as much as in low ejection fraction heart failure (HFrEF). Sacubitril–valsartan (S/V) has been shown to provide significant improvement in clinical outcomes in patients with HFrEF. The efficacy of S/V in patients with HFpEF was evaluated in PARAGON-HF study.


	Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy (PRADA) Dr. Oğuzhan Birdal
	Although developments in cancer treatment prolong life expectancy, the increase in cardiovascular side effects limits the treatment options and reduces the quality of life. Anthracyclines used in adjuvant breast cancer treatment and monoclonal antibodies such as trastuzumab and radiotherapy may have cardiotoxic effects.


	Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE-HTN TRIO): a randomised, multicentre, single-blind, sham-controlled trial Dr. Alper Karakuş
	In the RADIANCE-HTN SOLO study, endovascular renal denervation was shown to reduce blood pressure in patients with mild to moderate hypertension in 2 months of follow-up compared to the sham protocol.


	A Randomized Ablation-based atrial Fibrillation rhythm control versus rate control Trial in patients with heart failure and high burden Atrial Fibrillation (RAFT –AF) Dr. Oğuzhan Birdal
	Heart failure (HF) and atrial fibrillation (AF) often coexist and are associated with increased morbidity and mortality. Treatment of AF with catheter ablation in HF patients has been shown to have favorable outcomes compared with amiodarone, but more data are needed to compare this with rate control.


	Randomized Trial of Transfusion Strategies in Patients With Myocardial Infarction and Anemia- REALITY Dr. Alper Karakuş
	Observational studies of transfusion strategies in acute myocardial infarction (AMI) have yielded many confusing results. The CRIT and the MINT randomized pilot studies compared transfusion strategies in AMI patients in a limited number of study populations, and again conflicting results were presented.


	Femoropopliteal Endovascular Treatment With Paclitaxel-Coated Devices: SAFE-PAD Study Dr. Örsan Deniz URGUN
	Drug-coated devices used during femoropopliteal endovascular therapy have been associated with increased mortality, and these data were limited to small-scale studies.


	Effect of Genotype-Guided Oral P2Y12 Inhibitor Selection vs Conventional Clopidogrel Therapy on Ischemic Outcomes After Percutaneous Coronary InterventionThe TAILOR-PCI Randomized Clinical Trial Dr. Örsan Deniz URGUN
	After percutaneous coronary intervention, patients with CYP2C192 or 3 loss of-function (LOF) mutations treated with clopidogrel have an increased risk of ischemic events. It is unknown whether genotype-guided selection of oral P2Y12 inhibitor therapy improves ischemic outcomes.


	PRECOMBAT trial (Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stentin Patients with Left Main Coronary Artery Disease) Dr. Dursun AKASLAN
	Although coronary artery bypass grafting (CABG) has traditionally been the main treatment approach in the treatment of patients with left main coronary disease (LMCA), the use of drug-eluting stents is increasing day by day owing to the developments in stent technology.