Evidence in interventional cardiology

PCI for STEMI is superior to thrombolysis, even when performed routinely after thrombolysis (NORDISTEMI). PCI is also beneficial in NSTEMI patients (TACTICS-TIMI-18, RITA-3). However, in stable coronary artery disease it is much more controversial; COURAGE showed no benefit for PCI over medical therapy, though FAME-2 may have shown some benefit.

The use of drug-eluting stents appears to reduce revasculuarisation versus bare-metal stents(HORIZONS-AMI), though due to late stent thrombosis dual-antiplatelet therapy is recommended. However, this may not need to be continued after 6 months (PRODIGY).

Radial access appears as effective as femoral access and also safer (RIVAL).

Trans-aortic valve insertion (TAVI) appears a viable option versus surgery in high-risk patients and those not suitable for surgery (PARTNER).

Renal denervation appears to drop office blood pressures by over 30 mmHg in those with drug-resistant hypertension, though ambulatory drops are more modest (Symplicity HTN-2).