Reference: Fox y colaboradores. Short-term Outcomes of Acute Myocardial Infarction in Patients with Acute Kidney Injury: A Report from the National Cardiovascular Data Registry. Circulation 2012 (in press). The presence of chronic renal failure is common in patients referred for angioplasty. Its presence is associated with increased mortality and bleeding. However, the prevalence is unknown as...
Previous small studies have suggested that low-dose dopamine or neseritide can enhance congestive signs of acute heart failure without altering renal function. 360 patients were included within 24 hours of admission for heart failure with a glomerular filtration rate between 15 and 60 ml/min/1.73 m2. The primary endpoint was the improvement in the congestive signs...
Coronary angioplasty in patients with kidney failure is associated with an increased occurrence of events. This study compared the efficacy of preventing clinical restenosis using an everolimus-eluting stent versus a conventional stent, both implanted in the same patient with lesions in more than one vessel and suffering from kidney failure. The primary endpoint was target...
Failure of a mitral bioprosthesis always poses a challenge regarding decision-making, especially when dealing with elderly patients with multiple risk factors. The scenario is worsened by the high risk associated with a new sternotomy and the significant impact of undergoing new surgery. Transcatheter mitral valve-in-valve (TMViV) replacement is emerging as a valid strategy in the...
ALT FLOW device for left atrial to coronary sinus shunting in symptomatic heart failure patients. In the treatment of heart failure (HF), significant improvement in patient quality of life and prognosis has been achieved through appropriate medical treatment and, in some cases, the use of devices. However, in certain cases, satisfactory clinical improvement cannot be...
Contrast Induced Acute Kidney Injury (CI-AKI) is associated to increased costs and unfavorable results after hemodynamic procedures. Its incidence ranges between 2% and 7% according to the most recent literature. Multiple protection strategies have been analyzed in randomized studies, but no therapy has shown clear benefits. The RenalGuard (RG) is a device that uses furosemide-induced diuresis with...
Severe mitral regurgitation is associated to cardiac failure and hospitalization and over time is accompanied by kidney failure, which leads to higher mortality. In the COAPT study, in patients with low ejection fraction, MitraClip showed benefits over medical treatment, but there was an important group of people with kidney function deterioration. The evolution and benefit...
Currently, edge-to-edge therapy with MitraClip has demonstrated efficacy and safety for the treatment of patients with degenerative or functional mitral regurgitation who are at high risk for surgery. However, device-related complications are still present—though their frequency is subsiding due to greater experience, 3D doppler echocardiography development, and technological advancements: loss of leaflet insertion (LLI), single...
The full results of the EMPEROR-Preserved study confirm as findings that empagliflozin decreases the risk of death or hospitalization for heart failure (HF) in both patients with reduced and with preserved function. The primary endpoint (a composite of death and hospitalization for HF) was reduced by 21% on a relative basis with sodium/glucose cotransporter 2...
The DAPA-CKD trial has shown dapagliflozin, a SGLT2 receptor inhibitor, improves function, and reduces cardiovascular events and mortality. The latter is true regardless being or not diabetic. Patients with chronic kidney failure randomized to dapagliflozin saw improved kidney function, reduced cardiovascular events and increased survival rate. Primary end point, a combination of glomerular filtration deterioration...