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AHA 2021 Virtual: COVID-19 Limited Interventional Cardiology Trials

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AHA 2021 is in the rearview mirror, leaving behind a bevy of science still being digested, debated, and hopefully implemented thoughtfully. Many trials were presented, but for those of us focusing on intervention, there was limited new material as the AHA meeting each year is juxtaposed to the TCT Meeting, which dilutes the available new interventional science. Nonetheless, there were some noteworthy interventional-related studies.

But before the science, I must admit disappointment that AHA 2021 converted to a virtual-only format after first being announced as a hybrid conference. While the virtual and online meetings have improved technically, the lack of spontaneity surrounding presentations and questions before a live audience as well as the benefits of “hall discussions” is impossible to achieve regardless of chat rooms. I suspect many former attendees going forward will opt to read the online summaries or the early release articles and skip the virtual meeting altogether. 

So, what is really missing from live meetings? The energy of the participants. And this is not isolated to scientific formats. When Saturday Night Live (SNL) began its new “season” in October 2020, the producers realized the show required its usual live audience to be successful. At the time, New York City had banned audiences but did allow actors to work which led to the SNL workaround. SNL hired its audience members! I am not implying scientific venues should hire medical investigators as audience members, but I am suggesting that getting back to “live” venues as soon as safe is imperative. Going forward, hybrid venues provide the best of all opportunities – live if persons can safely attend, or digital as an alternative as needed to meet travel/time/safety/cost limitations. The result will be better discussions and energy for the sessions. TCT 2021, one month before, was hybrid and while attendance was not robust, there was an opportunity to interact and reintroduce more energy. From my perspective, it was unfortunate that the AHA ultimately chose to go entirely virtual as I feel we have gotten into a “cut and paste” mentality which is a deterrent to more open discussion which is really the cornerstone of scientific meetings.

As promised, I will briefly discuss trial of interest to the interventional community as the risk of bleeding with strong antiplatelet agents remains a significant risk. The REVERSE-IT Trial presented by Dr. Deepak Bhatt addressed as segment of that risk. Ticagrelor is a P2Y12 inhibiter which is not reversible by platelet transfusions and is associated with spontaneous bleeding as well as bleeding resulting from urgent surgery or invasive procedures. An intravenous Monoclonal Antibody – Bentracimab is a rapidly effective reversal agent which was assessed in patients with major bleeding or in need of urgent invasive or surgical procedures monitoring the effect on platelet inhibition measured by PRU with the Verify Now test. Bentracimab provided immediate and effective reversal of antiplalet effects of ticagrelor while providing good or excellent adjudicated hemostasis in greater than 90% of patients. A useful potential adjunct for management of life-threatening bleeding or risk thereof. 

Dr. Vetrovec reports no conflicts of interest.

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