The Most Read Articles of July in solaci website

1-Though Systolic BP Seems More Important, Diastolic BP Should Not Be Disregarded

Systolic hypertension is more often associated to cardiovascular events. However, diastolic blood pressure should not be disregarded, since it can also predict even worse outcomes.

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2-After Much Toing and Froing, Gastrointestinal Protection Is Back to the Forefront

Several clinical guidelines differ in their recommendation regarding the prescription of proton pump inhibitors to patients being treated with dual antiplatelet therapy after infarction. In 2015, the European Society of Cardiology (ESC) recommended their use in patients with high bleeding risk; however, in the 2017 update that recommendation became general after the assumption that, for all patients, the benefit outweighs the risk.

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3-Calcium Scoring: “Location” Seems to Be More Important than “Percentage”

The presence of a high percentage of calcium in the left main coronary artery is independently associated with a 20–30% greater risk for cardiovascular and all-cause death in asymptomatic adults. This highlights the fact that calcium location, and not only amount, is important. Calcium scoring reports from computerized tomography (CT) usually inform only that: how much calcium there is in the coronary tree. However, knowing its location seems to be equally or more important, and that should begin to be routinely informed as well.

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4-Many Guidelines, Much Confusion. Blood Pressure Targets in the Elderly

The AHA/ACC guidelines have lowered cohort hypertension thresholds to >130/80 mmHg, whereas the European guidelines have kept the classic >140/90 mmHg, though recommending lower thresholds for most patients at the same time. Lower than 130/80 mmHg is recommended with the exception of very frail patients and ≥65-year olds.

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5-DES with Bioresorbable Polymer vs. Bare Metal Stents in Primary PCI

Long after myocardial revascularization guidelines had established no medical reason justifies the use of bare metal stents (BMS), along comes this study to refresh the old trials comparing drug eluting vs bare metal stents in the context of primary PCI.

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6-5-Year Experience of Appendage Closure: More Evidence that Does Not Translate into Clinical Practice

The use of percutaneous left appendage closure increased 3.6-fold from 2011 to 2015, but this volume increase did not entail a significant uptrend of in-hospital events in this “real-world” population in Germany. However, can Germany be considered a real-world setting for Latin America? This question is warranted by the fact that there is no apparent volume increase for this technique in our region, which may be due to its cost or the lack of referral from clinicians to interventional cardiologists.

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7-Improved Outcomes after Lower Limb Revascularization

Operator ability combined with improved and diverse devices for lower limb revascularization has clearly increased in the last decade. However, is this technical feasibility we did not use to have translating into better clinical outcomes for patients, or is it simply inflating our interventionist egos?

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8-Clinical Implications of the New Hypertension Guidelines

Hypertension is the first modifiable risk factor affecting morbidity and mortality in nearly half of the adults in the US. The new ACC/AHA guidelines have issued new standards for the detection assessment and management of high blood pressure.

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9-Peri-Procedural Infarction in Angioplasty vs. Surgery in the Left Main Coronary Artery

According to the EXCEL trial, peri-procedural infarction was more common after left main coronary artery surgery compared with angioplasty, and it was strongly associated with increased 3-year mortality after controlling all possible confounding variables. This increased mortality was only present in extensive infarctions with an increase in CK-MB ≥10×.

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10-Dietary Supplements and Diets Show No Impact on Cardiovascular Risk

Americans spend billions in dietary supplements every year but, in truth, this money is only wasted, according to evidence form a recent study published in Intern Med.

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