Advancing the evidence base in interventional cardiology

The main advances in interventional cardiology in 2018 include the new European guidelines on revascularization, new developments in the treatment of cardiogenic shock, novel stent technology from Asia and clinical trial data showing no benefit of dropping aspirin after stenting. Key advances The 2018 ESC guidelines on myocardial revascularization provide the most up-to-date, evidence-based consensus recommendations 1 . For patients presenting with ST-segment elevation myocardial infarction, multivessel disease and cardiogenic shock, we now know that the acute intervention should be to treat the culprit vessel only 2 . New stent technologies with thin struts, absorbable polymers and reduced drug doses are proving to be equivalent to current technology in the first year after implantation and might show benefits with longer follow-up 3 . The first absorbable scaffolds have not met clinical expectations and have been removed from the market 4 . Ticagrelor monotherapy after stent implantation did not show a benefit at 2 years compared with standard dual antiplatelet therapy 5 .