1- What to Do with Blood Pressure Levels Between 130/80 and 139/89 mmHg
The decision to be made with a treatment-free patient with systolic blood pressure over 160 mmHg or diastolic blood pressure over 100 mmHg is an easy one. All guidelines agree: treatment should be started immediately alongside lifestyle changes.
2- FDA Alert on Drug-Coated Balloons and Stents in Femoropopliteal Artery Disease
The US Food and Drug Administration (FDA) has issued an alert on the potential long-term risk of paclitaxel-coated balloons and paclitaxel-eluting stents in patients with femoropopliteal artery disease.
3- ACC 2019 | STOPDAPT-2: P2Y12 Monotherapy After Short-Term Dual Antiplatelet Therapy After Angioplasty
Aspirin is against the ropes: first, it was primary prevention; now, its use is being reconsidered even in relation to angioplasty. There might be paradigm changes as regards antiplatelet therapy after angioplasty.
4- After 100,000+ Patients, TAVR Becomes the New Standard of Care
Eighty years did the trick for one the countries with more experience in transcatheter aortic valve replacement (TAVR), which made it the new “standard of care” to treat elderly patients.
5- ACC 2019 | SAFARI: Unexpectedly, Radial Approach Offers No Benefits In STEMI
This study was not able to show benefits in terms of mortality or bleeding when using radial vs. femoral approach in patients undergoing ST elevation myocardial Infarction.
6- ACC 2019 | AUGUSTUS: Apixaban Plus P2Y12 Inhibitor Is the Best Combination in Atrial Fibrillation and Angioplasty
Aspirin increases bleeding with no ischemic benefit, but a trend toward more stent thrombosis with placebo warrants further studies. Patients with atrial fibrillation who receive an anticoagulant agent and coronary angioplasty with a stent, and then continue with aspirin, experience an increased risk of bleeding without any ischemic benefit whatsoever.
7- The 10 Commandments of ESC’s New STEMI Guidelines
The authors have given an entertaining account of the most relevant points and differences between the new STEMI guidelines and the prior ones, from 2014. The article features 10 points resembling the ten commandments, which makes it easy to read, compared to the tedious task of reading the complete guidelines.
8- ACC 2019 | TAVR in Low-Risk Patients Is Noninferior
Self-expanding supraannular aortic valves have proved to be superior to surgery in high-risk patients and noninferior in intermediate-risk patients. However, the current challenge is posed by low-risk, generally younger, patients. In that sense, our purpose is to determine device effectiveness and safety in terms of mortality and stroke rates (which are low with surgery), their risk for complications, and—particularly—their durability.
9- Asymptomatic Coronary Artery Disease, Silent Ischemia: A Cardiologist’s Headache
We need more evidence to guide us in the management of silent ischemia. Confirmed asymptomatic coronary artery disease is a problem for cardiologists, who lack enough evidence to guide a risk-benefit assessment that justifies revascularization. Revascularizing the outcome of a functional assessment may reduce the rates of death and infarction, or it may just be an appeasing placebo for both patient and primary care physician (without taking into account the risks inherent to the procedure).
10- ACC 2019 | SMART-CHOICE: Aspirin Increasingly “Against the Ropes”
This work (presented during the same American College of Cardiology [ACC] 2019 Scientific Session as the STOPDAPT-2 trial) enrolled 2993 patients who underwent angioplasty with current-generation stents Xience, Promus, Synergy, or Orsiro at 33 Korean sites. Patients were randomized to 12 months of dual antiplatelet therapy or dropping aspirin at 3 months.
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