Highlights of Transcatheter Cardiovascular Therapeutics 2019

ranscatheter Cardiovascular Therapeutics (TCT) is an annual scientific congress sponsored and organized by the Cardiovascular Research Foundation in New York, and is dedicated to the optimal management of patients with coronary, peripheral vascular, and structural heart disease.While highlighting less invasive percutaneous strategies to treat cardiovascular disorders, TCT emphasizes the appropriate integration of medical, surgical, and transcatheter therapies to improve patient outcomes, stressing a heart team patient-centered approach.The essence of TCT is the appropriate application of evidence-based medicine to an inherently procedural-based specialty.TCT equally underscores the complementary roles of rigorous scientific evidence and experiential learning through live and taped cases.Moreover, at the core of TCT is a passion for innovation and invention, which enables the next transformative breakthroughs that will change patient care.TCT 2019, the 31st annual symposium, was held from September 25th through September 29th in the Moscone Conference Center in San Francisco, CA, and was attended by ≈11 500 attendees from 104 countries, including >1500 faculty, featuring the next generation of global interventional leaders.Highlights of TCT 2019 included 193 sessions over 5 days with >2000 lectures, >40 live case transmissions from 15 sites from 8 countries, 28 Late Breaking Trials and Late Breaking Clinical Science presentations, 36 High Impact Clinical Research presentations, ≈1000 peer-reviewed abstract presentations, ≈630 peer-reviewed challenging case presentations, 31 simultaneous peer-reviewed publications in high-impact journals, 6 Training Pavilions with >3000 physician training experiences, the FDA Town Hall Meeting and FDA University, the Shark Tank innovation competition, the 28th annual Cardiovascular Professionals course for nurses and technologists, ≈176 exhibitors with 61 satellite educational programs, and much more.The Late Breaking Trials provided practice-changing, randomized clinical evidence across the spectrum of interventional cardiovascular medicine (Table).Among the highlights: the highly anticipated TWILIGHT trial (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention) was a multicenter, placebo-controlled, double-blind, randomized study testing the safety and effectiveness of ticagrelor monotherapy in comparison with ticagrelor plus aspirin in 7119 high-risk patients who were stable on dual antiplatelet therapy 3 months after percutaneous coronary intervention (PCI).Ticagrelor monotherapy between 3 and 15 months resulted in lower rates of major bleeding without increasing the risk of ischemic events in comparison with aspirin plus ticagrelor. 1 These findings, in concert with prior evidence from other studies, emphasize the importance of personalizing antithrombotic regimens to minimize hemorrhagic complications while preserving ischemic efficacy.